Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1982296877 Individual Practitioner Male Practitioner

Dr. Tyson Wallace , PharmD

Pharmacist • Gosnell, AR

Professional Overview & Biography Verified Profile Summary

Dr. Tyson Wallace, PharmD is a registered healthcare professional specializing in Pharmacist in Gosnell, AR. Practice services are available at 134 BEVILL AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

134 Bevill Ave

Gosnell, AR 72315

Telephone 8707519242
Fax 8707519291
Associated Practice Facility / Clinic
🏢 Gosnell Drugs Inc. Facility NPI 1770055923

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Gosnell, AR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.5 Yrs
Regional Practice Density
3 Specialists

Practicing in Gosnell, AR (2976 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-04-22
Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License AR PD09924

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Pharmacist

NUCC Taxonomy Code: 183500000X

State License MO 2007005629

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
289547795 (AR)

Secondary Practice Locations

339 E Commercial St

Senath, MO 638769238

Phone: 5737382097

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1649095852
NPI 1912599895

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active February 11, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location February 11, 2021

Registered at 134 BEVILL AVE, GOSNELL, AR 72315 (Tel: 8707519242)

📍
Updated Business Mailing Address February 11, 2021

Registered at 134 BEVILL AVE, GOSNELL, AR 72315 (Tel: 8707519242)

👤
Provider Name / Credentials Updated February 11, 2021

Recorded as TYSON WALLACE, PHARM. D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 11, 2021

Pharmacist (License #2007005629 in MO)

🟢
Initial NPI Registration & Enumeration February 11, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982296877
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 11, 2021
Last Update: April 22, 2025
Sole Proprietor: No

Mailing Address

134 Bevill Ave

Gosnell, AR 72315

Phone: 8707519242

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.