DR. James Edwards Wallace JR., MD

NPI #1063464006 in Pineville, Louisiana

Provider Information

NPI Number: 1063464006
Entity Type: Individual
Name: DR. James Edwards Wallace JR., MD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Family Medicine
Credential: MD
Enumeration Date: May 17, 2006
Last Updated: Jun 19, 2014

Practice Location

Address: 1135 EXPRESSWAY DR
Address 2: SUITE 200 A
City: Pineville
State: Louisiana
ZIP Code: 71360-6698
Phone: (318) 561-9600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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