Donald R. Wallace in Peoria - Emergency Medicine
Donald R. Wallace - NPI 1700899788
Donald R. Wallace is a Emergency Medicine in Peoria, Illinois. Donald R. Wallace practices all healthcare services and medical treatments related to Emergency Medicine. The NPI Number for Donald R. Wallace is 1700899788. The last update date is 2010-07-29.
Donald R. Wallace's current location address is 5114 N Glen Park Place Rd, Peoria, Illinois. You can contact this provider via phone number 3096836600. The mailing address for Donald R. Wallace is 5114 N Glen Park Place Rd, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Donald R. Wallace |
|---|---|
| Address | 5114 N Glen Park Place Rd, Peoria, Illinois |
| Phone Number | 3096836600 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1700899788 |
|---|---|
| Provider Enumeration Date | 2006-08-14 |
| Last Updated Date | 2010-07-29 |
Provider Mailing Address Detail
| Address | 5114 N Glen Park Place Rd |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616144686 |
| Phone Number | 3096836600 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Emergency Medicine |
|---|---|
| Taxonomy | 207P00000X |
| Licence No | 036-077680 |
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Definition: An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 36077680 | IL | -- | |
| 809840034 | IL | MEDICARE INDIVIDUAL PTAN | |
| 800810 | MEDICARE GROUP NO. | ||
| 809840 | IL | MEDICARE GROUP PTAN |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Donald R. Wallace by the Centers for Medicare & Medicaid Services?
The Donald R. Wallace has been assigned the NPI (National Provider Identifier) 1700899788 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you kindly provide the complete physical address where Donald R. Wallace's facilities are geographically located?
The facilities of Donald R. Wallace are physically situated at the following location: 5114 N Glen Park Place Rd, Peoria, IL, 616144686.
What is Donald R. Wallace's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Donald R. Wallace is Emergency Medicine, and the taxonomy classification code that categorizes this area of expertise is 207P00000X.
When did Donald R. Wallace receive its 1700899788 assignment?
The Donald R. Wallace was assigned its 1700899788 on 2006-08-14, which is the date when this unique identifier was issued to the organization.
When was the information regarding Donald R. Wallace most recently updated?
The details pertaining to the Donald R. Wallace, including its address, specialty, and other relevant information, were last refreshed on 2010-07-29.
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