Kacey L Wallace, DO

NPI #1306868534 in Chickasha, Oklahoma

Provider Information

NPI Number: 1306868534
Entity Type: Individual
Name: Kacey L Wallace, DO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: DO
Enumeration Date: Jul 24, 2006
Last Updated: Nov 24, 2023

Practice Location

Address: 1000 W CHOCTAW AVE STE 9
City: Chickasha
State: Oklahoma
ZIP Code: 73018
Phone: (405) 544-2940

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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