DR. Jennifer Wallace, M.D.

NPI #1912977885 in Gilbert, Arizona

Provider Information

NPI Number: 1912977885
Entity Type: Individual
Name: DR. Jennifer Wallace, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pediatrics
Credential: M.D.
Enumeration Date: Jan 24, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 2550 E GUADALUPE RD
Address 2: #115
City: Gilbert
State: Arizona
ZIP Code: 85234-5114
Phone: (480) 632-1544

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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