Jody Paul Wallace in Graham - General Practice
Jody Paul Wallace - NPI 1740210103
Jody Paul Wallace is a General Practice in Graham, North Carolina. Jody Paul Wallace practices all healthcare services and medical treatments related to General Practice. The NPI Number for Jody Paul Wallace is 1740210103. The last update date is 2007-07-08.
Jody Paul Wallace's current location address is 2148 Highway 54, Graham, North Carolina. You can contact this provider via phone number 3365783884 and fax number 3365783814. The mailing address for Jody Paul Wallace is 2148 Highway 54, Graham, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jody Paul Wallace |
|---|---|
| Address | 2148 Highway 54, Graham, North Carolina |
| Phone Number | 3365783884 |
| Fax Number | 3365783814 |
| Sole Proprietor | N |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1740210103 |
|---|---|
| Provider Enumeration Date | 2006-07-03 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2148 Highway 54 |
|---|---|
| City | Graham |
| State | North Carolina (NC) |
| Post Code | 27253 |
| Phone Number | 3365783884 |
| Fax Number | 3365783814 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 7500 |
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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 |
|---|---|---|---|
| 89902J1 | NC | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Jody Paul Wallace by the Centers for Medicare & Medicaid Services?
The Jody Paul Wallace has been issued the NPI (National Provider Identifier) 1740210103, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Jody Paul Wallace's physical address?
The Jody Paul Wallace is physically located at 2148 Highway 54, in the city of Graham, NC, with the postal code 27253.
What is Jody Paul Wallace's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jody Paul Wallace's area of specialization is General Practice, and the corresponding taxonomy code that categorizes this field of practice is 1223G0001X.
When did Jody Paul Wallace receive its 1740210103 assignment?
The Jody Paul Wallace was assigned its 1740210103 on 2006-07-03, which is the date when this unique identifier was issued to the organization.
As of what date were the details pertaining to Jody Paul Wallace last refreshed?
The information related to the Jody Paul Wallace, including its address, specialty, and other relevant details, was last updated on 2007-07-08.
NPI Number: 1720081763
Address: 675 E Highway 60, Hardinsburg, KY