Charles R. Wallace, Jr., Md

LBN: Charles R. Wallace, Jr., Md
Charles R. Wallace, Jr., Md is an health care organization with primary practice located at 1325 Eastmoreland Ave Ste 425 , Memphis TN 38104-7541. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as the primary health care specialty. Charles R. Wallace, Jr., Md can be contacted via phone (901) 272-3200, or through Wallace, Ann Marie via phone (901) 272-3200.

Contact Information

Primary practice address
1325 Eastmoreland Ave Ste 425 Memphis TN 38104-7541
Phone: (901) 272-3200
Fax: (901) 278-3441
Website:
Map and Directions
Authorized official contact:
Name: Wallace, Ann Marie
Phone: (901) 272-3200

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X

Profile Details

NPI number 1558522367
LBN Legal business name Charles R. Wallace, Jr., Md
DBA Doing business as
Authorized official Wallace, Ann Marie
Entity Organization
Organization subpart 1 No
Enumeration date Jun 24th, 2008
Last updated Jun 24th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558522367 NPPES
Tennessee Other 0040441 BCBS

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