NPI 1083608053

Douglas W Wallace, MD

Practitioner Diagnostic Radiology Physician Columbus, GA

Practice location

Address: 2300 Manchester Expy STE A001, Columbus, GA 31904-6802
Phone: (706) 257-7700
Fax: (706) 257-7708
Mailing address: P.O. Box 9145, Columbus, GA 31908-9145

Registered specialties (2)

Diagnostic Radiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 014966 (GA)

Other Radiology providers in Georgia →

Diagnostic Radiology Physician

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 14966 (GA)

Registry record

NPI: 1083608053
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Sep 2005
Record last updated: 27 Jul 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.