Richard Edwin Waller, M.D.
NPI #1821001041 in Marks, Mississippi
Provider Information
- NPI Number
- 1821001041
- Entity Type
- Individual
- Name
- Richard Edwin Waller, M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Family Medicine
- Credential
- M.D.
- Enumeration Date
- Aug 15, 2006
- Last Updated
- Mar 1, 2017
Practice Location
- Address
- 1024 MARTIN LUTHER KING DRIVE
- City
- Marks
- State
- Mississippi
- ZIP Code
- 38646-0289
- Phone
- (662) 326-3502
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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