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
Fax: (859) 257-2418
Website:

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.

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Identifiers

StateTypeNumberIssuer
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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