Wallace Medical Group

NPI #1942623939 in Chandler, Arizona

Provider Information

NPI Number: 1942623939
Entity Type: Organization
Organization Name: Wallace Medical Group
Primary Specialty: Specialist
Enumeration Date: Jan 27, 2014
Last Updated: Jan 27, 2014

Practice Location

Address: 1986 E GLACIER PL
City: Chandler
State: Arizona
ZIP Code: 85249-2886
Phone: (520) 245-7379

Authorized Official

Name: ROBERT WALLACE, BS
Title: CHIEF EXECUTIVE OFFICER
Phone: (520) 245-7379

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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