Tracey C Wallace in Marietta - Family Medicine
Tracey C Wallace - NPI 1265475206
Tracey C Wallace is a Family Medicine in Marietta, Georgia. Tracey C Wallace practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Tracey C Wallace is 1265475206. The last update date is 2021-02-26.
Tracey C Wallace's current location address is 1121 Johnson Ferry Rd, Marietta, Georgia. You can contact this provider via phone number 7705091025. The mailing address for Tracey C Wallace is 1121 Johnson Ferry Rd, Marietta, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tracey C Wallace |
|---|---|
| Address | 1121 Johnson Ferry Rd, Marietta, Georgia |
| Phone Number | 7705091025 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1265475206 |
|---|---|
| Provider Enumeration Date | 2006-06-14 |
| Last Updated Date | 2021-02-26 |
Provider Mailing Address Detail
| Address | 1121 Johnson Ferry Rd |
|---|---|
| City | Marietta |
| State | Georgia (GA) |
| Post Code | 300685425 |
| Phone Number | 7705091025 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 42483 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00777697A | GA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Tracey C Wallace by the Centers for Medicare & Medicaid Services?
The Tracey C Wallace has been issued the NPI (National Provider Identifier) 1265475206 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Tracey C Wallace?
The Tracey C Wallace is physically situated at 1121 Johnson Ferry Rd, in the city of Marietta, state of GA, with the postal code 300685425.
What is Tracey C Wallace's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Tracey C Wallace is Family Medicine, and the corresponding taxonomy classification code for this specialized field is 207Q00000X.
On what date was the 1265475206 assigned to Tracey C Wallace?
The Tracey C Wallace was issued its 1265475206 on 2006-06-14, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Tracey C Wallace most recently updated?
The details pertaining to the Tracey C Wallace, including its address, specialty, and other relevant information, were last refreshed on 2021-02-26.
NPI Number: 1982607495
Address: 12623 E 86th St, Indianapolis, IN