Wallace, Roxanne Elizabeth
Wallace, Roxanne Elizabeth is an individual health care provider with primary practice located at 650 Joel Dr , Fort Campbell KY 42223. She recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as her primary health care specialty. Wallace, Roxanne Elizabeth can be contacted via phone (270) 798-7694.Contact Information
Primary practice address
650 Joel Dr
Fort Campbell KY 42223
Phone: (270) 798-7694
Fax: (270) 798-8630
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 14950 | New Hampshire |
Profile Details
| NPI number | 1609959451 |
|---|---|
| LBN Legal business name | Wallace, Roxanne Elizabeth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 23rd, 2006 |
| Last updated | Feb 5th, 2019 - about 5 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 | 1609959451 | NPPES |
| New Hampshire | MEDICAID | 001741101 |
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