David Richard Wallace in Lake Charles - Pediatrics
David Richard Wallace - NPI 1619968146
David Richard Wallace is a Pediatrics in Lake Charles, Louisiana. David Richard Wallace practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for David Richard Wallace is 1619968146. The last update date is 2007-07-08.
David Richard Wallace's current location address is 2903 1st Ave, Lake Charles, Louisiana. You can contact this provider via phone number 3374786480 and fax number 3374749637. The mailing address for David Richard Wallace is 2903 1st Ave, Lake Charles, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | David Richard Wallace |
|---|---|
| Address | 2903 1st Ave, Lake Charles, Louisiana |
| Phone Number | 3374786480 |
| Fax Number | 3374749637 |
| Sole Proprietor | X |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1619968146 |
|---|---|
| Provider Enumeration Date | 2005-11-03 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2903 1st Ave |
|---|---|
| City | Lake Charles |
| State | Louisiana (LA) |
| Post Code | 706018809 |
| Phone Number | 3374786480 |
| Fax Number | 3374749637 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 208000000X |
| Licence No | 15614 |
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Definition: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1329762 | LA | -- |
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What is the unique identifier code issued to David Richard Wallace by the Centers for Medicare & Medicaid Services (CMS)?
The David Richard Wallace has been assigned the NPI (National Provider Identifier) 1619968146. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the David Richard Wallace located?
The David Richard Wallace is located at 2903 1St Ave, Lake Charles, LA 706018809.
What is David Richard Wallace's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for David Richard Wallace is Pediatrics, and the taxonomy code that classifies this field of practice is 208000000X.
On what date did David Richard Wallace receive its 1619968146 assignment from the Centers for Medicare & Medicaid Services?
The David Richard Wallace was assigned its 1619968146 on 2005-11-03, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the David Richard Wallace's details last updated?
The information pertaining to the David Richard Wallace, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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