Weatherly, Wallace W

Weatherly, Wallace W is an individual health care provider with primary practice located at 1801 Crane Ridge Dr Suite C, Jackson MS 39216-4902. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Weatherly, Wallace W can be contacted via phone (601) 981-5633.

Contact Information

Primary practice address
1801 Crane Ridge Dr Suite C Jackson MS 39216-4902
Phone: (601) 981-5633
Fax: (601) 981-1844
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 11796 Mississippi

Profile Details

NPI number 1972558542
LBN Legal business name Weatherly, Wallace W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated Dec 19th, 2017 - about 8 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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