Wallace, Thomas Everett
Wallace, Thomas Everett is an individual health care provider with primary practice located at 740 S Limestone L543, Kentucky Clinic, Lexington KY 40536-0284. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Wallace, Thomas Everett can be contacted via phone (859) 323-5045.Contact Information
Primary practice address
740 S Limestone L543, Kentucky Clinic
Lexington KY 40536-0284
Phone: (859) 323-5045
Fax: (859) 257-2418
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | MD23936 | Tennessee |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 30857 | West Virginia |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 43982 | Kentucky |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 43982 | Kentucky |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 43982 | Kentucky |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 30857 | West Virginia |
Profile Details
| NPI number | 1700822822 |
|---|---|
| LBN Legal business name | Wallace, Thomas Everett |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2006 |
| Last updated | Nov 2nd, 2021 - about 3 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 | 1700822822 | NPPES |
| Tennessee | MEDICAID | 33270961 | |
| Tennessee | Other | 4123936 | |
| Tennessee | Other | 4158379 | |
| Tennessee | MEDICAID | 201256750 | |
| Tennessee | Other | P00317082 | |
| Tennessee | MEDICAID | 3327097 | |
| Tennessee | MEDICAID | 30707611 |
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