NPI 1144335290

Gary Wayne Wallace, MD

Practitioner Ophthalmology Physician Idaho Falls, ID

Practice location

Address: 2295 Coronado Street, Idaho Falls, ID 83404
Phone: (208) 524-8600
Fax: (208) 524-8394

Registered specialties

Ophthalmology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207W00000X Licence M-6226 (ID)

Other Ophthalmology providers in Idaho →

Registry record

NPI: 1144335290
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Aug 2006
Record last updated: 26 May 2011

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.