Wallace, Lawrence
Wallace, Lawrence is an individual health care provider with primary practice located at 790 Bryan St Suite 1, Huntingdon PA 16652-2410. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Wallace, Lawrence can be contacted via phone (814) 643-8484.Contact Information
Primary practice address
790 Bryan St Suite 1
Huntingdon PA 16652-2410
Phone: (814) 643-8484
Fax: (814) 643-8487
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 0101234728 | Virginia |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | MD439714 | Pennsylvania |
Profile Details
| NPI number | 1679567192 |
|---|---|
| LBN Legal business name | Wallace, Lawrence |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 12th, 2005 |
| Last updated | Jul 27th, 2012 - about 12 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 | 1679567192 | NPPES |
| Virginia | MEDICAID | 010114446 |
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