Wallace, Lucy Brooks
Wallace, Lucy Brooks is an individual health care provider with primary practice located at 275 Collier Road Nw Suite 470, Atlanta GA 30309. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery, Allopathic & Osteopathic Physicians / Surgical Oncology. Allopathic & Osteopathic Physicians / Surgery is her primary health care specialty. Wallace, Lucy Brooks can be contacted via phone (404) 351-1002.Contact Information
Primary practice address
275 Collier Road Nw Suite 470
Atlanta GA 30309
Phone: (404) 351-1002
Fax: (404) 350-8290
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | N4832 | Texas |
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | N4832 | Texas |
| Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | N4832 | Texas |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 77806 | Georgia |
Profile Details
| NPI number | 1770787566 |
|---|---|
| LBN Legal business name | Wallace, Lucy Brooks |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2007 |
| Last updated | Jan 18th, 2023 - about last year |
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 | 1770787566 | NPPES |
| Georgia | MEDICAID | 003193207A |
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