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DR. JAMES G WALLACE M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1760683924

Individual Registrant:
DR. JAMES G WALLACE M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
525 JAY AVE  BREWSTER, WA 98812-3403 US
Tel: 509-422-5700  Fax: 509-422-7680

Contact information for business:
PO BOX 1340 STE 100 OKANOGAN, WA 98840-1340 US
Tel: 509-422-5700  Fax: --

Registration Information:
NPI: 1760683924
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
WA60167526

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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