Wallace, Arthur G
Wallace, Arthur G is an individual health care provider with primary practice located at 1717 S Utica Ave Ste A , Tulsa OK 74104-5346. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Wallace, Arthur G can be contacted via phone (918) 748-7557.Contact Information
Primary practice address
1717 S Utica Ave Ste A
Tulsa OK 74104-5346
Phone: (918) 748-7557
Fax: (918) 748-7514
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | 1864 | Oklahoma |
Profile Details
NPI number | 1225026206 |
---|---|
LBN Legal business name | Wallace, Arthur G |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 12th, 2005 |
Last updated | Apr 13th, 2010 - about 14 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1225026206 | NPPES |
Oklahoma | MEDICAID | 100228470B |
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