Wallace, Perry

Wallace, Perry is an individual health care provider with primary practice located at 2121 5Th St Suite 202, Meridian MS 39301-5108. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Wallace, Perry can be contacted via phone (601) 286-3410.

Contact Information

Primary practice address
2121 5Th St Suite 202 Meridian MS 39301-5108
Phone: (601) 286-3410
Fax: (601) 286-3425
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 29610 Tennessee
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 10491 Mississippi
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 10491 Mississippi
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 13895 Alabama

Profile Details

NPI number 1922044502
LBN Legal business name Wallace, Perry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Nov 14th, 2011 - about 13 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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Identifiers

StateTypeNumberIssuer
All States NPI 1922044502 NPPES
Georgia MEDICAID 417498226A
Georgia MEDICAID 3331790

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