William H. Wallace

Practice location

Address

1421 N State St # St.1 STE. 504, Jackson, MS 39202-1658

Phone

(601) 969-9050

Fax

(601) 354-2443

Registered specialties

Registry record

NPI

1437184017

Entity type

Individual

Sex (as registered)

Male

NPI issued

11 Jul 2006

Record last updated

8 Jul 2007

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.