Bradley A Wallace in Jacksonville - Neurological Surgery
Bradley A Wallace - NPI 1134160161
Bradley A Wallace is a Neurological Surgery in Jacksonville, Florida. Bradley A Wallace practices all healthcare services and medical treatments related to Neurological Surgery. The NPI Number for Bradley A Wallace is 1134160161. The last update date is 2016-06-09.
Bradley A Wallace's current location address is 800 Prudential Dr, Jacksonville, Florida. You can contact this provider via phone number 9043886518 and fax number 9043841005. The mailing address for Bradley A Wallace is 800 Prudential Dr, Jacksonville, Florida. To know further, please read the information below!
Provider Profile Detail
Provider Name | Bradley A Wallace |
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Address | 800 Prudential Dr, Jacksonville, Florida |
Phone Number | 9043886518 |
Fax Number | 9043841005 |
Sole Proprietor | N |
Credentials | MD |
NPI Number Detail
NPI Number | 1134160161 |
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Provider Enumeration Date | 2006-06-09 |
Last Updated Date | 2016-06-09 |
Provider Mailing Address Detail
Address | 800 Prudential Dr |
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City | Jacksonville |
State | Florida (FL) |
Post Code | 322078202 |
Phone Number | 9043886518 |
Fax Number | 9043841005 |
Provider's Primary Taxonomy Detail
Speciality | Neurological Surgery |
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Taxonomy | 207T00000X |
Licence No | ME91779 |
Definition: A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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2744978500 | FL | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Bradley A Wallace by the Centers for Medicare & Medicaid Services?
The Bradley A Wallace has been assigned the NPI (National Provider Identifier) 1134160161 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Bradley A Wallace's facilities are situated?
The facilities of Bradley A Wallace are physically located at the following address: 800 Prudential Dr, Jacksonville, FL, 322078202.
What is Bradley A Wallace's specialized field of practice, and what is the corresponding taxonomy classification code?
The Bradley A Wallace's area of specialization is Neurological Surgery, and the corresponding taxonomy code that categorizes this field of practice is 207T00000X.
On what date was the 1134160161 assigned to Bradley A Wallace?
The Bradley A Wallace was issued its 1134160161 on 2006-06-09, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Bradley A Wallace, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Bradley A Wallace, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2016-06-09.