Dr. Jeffrey H Wallen
Oral & Maxillofacial Surgeon
1200 48th Ave N Suite 101
Myrtle Beach
, South Carolina 29577-5425
Dr. Jeffrey H Wallen
Oral & Maxillofacial Surgeon
1200 48th Ave N Suite 101
Myrtle Beach
, South Carolina 29577-5425
(843) 497-0647
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About
Features
Specialties
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Jeffrey H Wallen
- 1200 48th Ave N Suite 101
- Myrtle Beach, SC
- Zip : 29577-5425
- Fax : (843) 497-0647
- Phone : (843) 449-4993
Second Address
- Dr. Jeffrey H Wallen
- 1200 48th Ave N Suite 101
- Myrtle Beach, SC
- Zip : 29577-5425
- Fax : (843) 497-0647
- Phone : (843) 449-4993
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgeon | 2959 | SC |
National Provider Identifier
| NPI | 1497729396 |
|---|---|
| Provider Name | Dr. Jeffrey H Wallen |
| First Address | Myrtle Beach, SC 29577-5425 |
| Second Address | Myrtle Beach, SC 29577-5425 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/02/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 8998844 | (05) | NC |
| U56498 | (02) | |
| ZA9905 | (05) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.