NPI 1225122567

Jerold W Wallis, MD

Practitioner Nuclear Medicine Physician Saint Louis, MO

Practice location

Address: 510 S Kingshighway Blvd Dept Radiology, Saint Louis, MO 63110-1016
Phone: (314) 362-7200
Fax: (314) 747-4189
Mailing address: PO Box 7412011, Chicago, IL 60674-2011

Registered specialties

Nuclear Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207U00000X Licence R9F90 (MO)

Other Nuclear Medicine providers in Missouri →

Registry record

NPI: 1225122567
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Oct 2006
Record last updated: 17 Apr 2025

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.