James E. Wallace, Jr, M.D., Llc

LBN: James E. Wallace, Jr, M.D., Llc
James E. Wallace, Jr, M.D., Llc is an health care organization with primary practice located at 1135 Expressway Dr Suite 200 A, Pineville LA 71360-6698. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. James E. Wallace, Jr, M.D., Llc can be contacted via phone (318) 561-9600, or through Bailey, Tina Dewitt via phone (318) 561-9600.

Contact Information

Primary practice address
1135 Expressway Dr Suite 200 A Pineville LA 71360-6698
Phone: (318) 561-9600
Fax: (318) 561-0228
Website:
Map and Directions
Authorized official contact:
Name: Bailey, Tina Dewitt CPC
Phone: (318) 561-9600

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD.200134 Louisiana

Profile Details

NPI number 1568652485
LBN Legal business name James E. Wallace, Jr, M.D., Llc
DBA Doing business as
Authorized official Bailey, Tina Dewitt CPC
Entity Organization
Organization subpart 1 No
Enumeration date Jul 26th, 2007
Last updated Nov 14th, 2007 - about 17 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1568652485 NPPES
Louisiana MEDICAID 1627950

Popular Providers