Wallace, John K
Wallace, John K is an sole proprietor health care provider with primary practice located at 2664 Hartford Hwy , Dothan AL 36305-4904. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Wallace, John K can be contacted via phone (334) 699-2244.Contact Information
Primary practice address
2664 Hartford Hwy
Dothan AL 36305-4904
Phone: (334) 699-2244
Fax: (334) 699-2245
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 00013178 | Alabama |
Profile Details
| NPI number | 1992735302 |
|---|---|
| LBN Legal business name | Wallace, John K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 3rd, 2006 |
| Last updated | Mar 22nd, 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 | 1992735302 | NPPES |
| Alabama | MEDICAID | 000046695 |
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