Terry Eugene Wallace in Idabel - Addiction (substance Use Disorder)
Terry Eugene Wallace - NPI 1831304922
Terry Eugene Wallace is a Addiction (substance Use Disorder) in Idabel, Oklahoma. Terry Eugene Wallace practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Terry Eugene Wallace is 1831304922. The last update date is 2007-07-08.
Terry Eugene Wallace's current location address is 104 Ne Avenue A, Idabel, Oklahoma. You can contact this provider via phone number 5802863301. The mailing address for Terry Eugene Wallace is 104 Ne Avenue A, Idabel, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Terry Eugene Wallace |
|---|---|
| Address | 104 Ne Avenue A, Idabel, Oklahoma |
| Phone Number | 5802863301 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | CADC |
NPI Number Detail
| NPI Number | 1831304922 |
|---|---|
| Provider Enumeration Date | 2007-05-11 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 104 Ne Avenue A |
|---|---|
| City | Idabel |
| State | Oklahoma (OK) |
| Post Code | 74745 |
| Phone Number | 5802863301 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 71 |
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Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
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Post Comment/ Review Below
What is the unique 10-digit identification code issued to Terry Eugene Wallace by the Centers for Medicare & Medicaid Services?
The Terry Eugene Wallace has been assigned the NPI (National Provider Identifier) 1831304922 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Terry Eugene Wallace's physical address?
The Terry Eugene Wallace is physically located at 104 Ne Avenue A, in the city of Idabel, OK, with the postal code 74745.
What is Terry Eugene Wallace's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Terry Eugene Wallace is Addiction (substance Use Disorder), and the corresponding taxonomy classification code for this specialized field is 101Ya0400X.
On what date did Terry Eugene Wallace receive its 1831304922 assignment from the Centers for Medicare & Medicaid Services?
The Terry Eugene Wallace was assigned its 1831304922 on 2007-05-11, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Terry Eugene Wallace most recently updated?
The details pertaining to the Terry Eugene Wallace, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.