Brian Wallace in Prestonsburg - General Practice
Brian Wallace - NPI 1093866121
Brian Wallace is a General Practice in Prestonsburg, Kentucky. Brian Wallace practices all healthcare services and medical treatments related to General Practice. The NPI Number for Brian Wallace is 1093866121. The last update date is 2007-07-08.
Brian Wallace's current location address is 781 S Lake Dr, Prestonsburg, Kentucky. You can contact this provider via phone number 6068862676 and fax number 6068862741. The mailing address for Brian Wallace is 781 S Lake Dr, Prestonsburg, Kentucky. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brian Wallace |
|---|---|
| Address | 781 S Lake Dr, Prestonsburg, Kentucky |
| Phone Number | 6068862676 |
| Fax Number | 6068862741 |
| Sole Proprietor | Y |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1093866121 |
|---|---|
| Provider Enumeration Date | 2007-01-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 781 S Lake Dr |
|---|---|
| City | Prestonsburg |
| State | Kentucky (KY) |
| Post Code | 416531340 |
| Phone Number | 6068862676 |
| Fax Number | 6068862741 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 7008 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 60070083 | KY | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Brian Wallace by the Centers for Medicare & Medicaid Services?
The Brian Wallace has been assigned the NPI (National Provider Identifier) 1093866121. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Brian Wallace?
The Brian Wallace is physically situated at 781 S Lake Dr, in the city of Prestonsburg, state of KY, with the postal code 416531340.
What is the Brian Wallace's area of specialization and corresponding taxonomy classification?
The Brian Wallace's specialty field is General Practice, and it falls under the taxonomy code 1223G0001X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1093866121 to Brian Wallace?
The Centers for Medicare & Medicaid Services originally issued the 1093866121 to Brian Wallace on 2007-01-16.
As of what date were the details related to Brian Wallace most recently updated or revised?
The information pertaining to Brian Wallace, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.