NPI 1780614529

Eric Lee Wallace, MD

Practitioner Surgery Physician Cookeville, TN

Practice location

Address: 145 W 4th St STE 201, Cookeville, TN 38501-2476
Phone: (931) 783-5515
Fax: (931) 783-5513
Mailing address: 140 W 7th St, Cookeville, TN 38501-1726

Registered specialties

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 71205 (TN)

Other Surgery providers in Tennessee →

Registry record

NPI: 1780614529
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Jul 2006
Record last updated: 14 Oct 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.