Wallace, Amy Jo
Wallace, Amy Jo is an individual health care provider with primary practice located at 861 Old Winston Rd Ste 101 , Kernersville NC 27284-7141. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wallace, Amy Jo can be contacted via phone (336) 904-0143.Contact Information
Primary practice address
861 Old Winston Rd Ste 101
Kernersville NC 27284-7141
Phone: (336) 904-0143
Fax: (336) 904-0046
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 26169 | South Carolina |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 200600865 | North Carolina |
Profile Details
| NPI number | 1467487322 |
|---|---|
| LBN Legal business name | Wallace, Amy Jo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Nov 4th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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