Dr. Richard Peterkin Wallace
Family Doctor Family Doctor - Sports Medicine
1001 S Fort Harrison Ave Suite 101
Clearwater
, Florida 33756-3941
Dr. Richard Peterkin Wallace
Family Doctor Family Doctor - Sports Medicine
1001 S Fort Harrison Ave Suite 101
Clearwater
, Florida 33756-3941
(727) 441-5008
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About
Features
Specialties
- Family Doctor
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Richard Peterkin Wallace
- 1001 S Fort Harrison Ave Suite 101
- Clearwater, FL
- Zip : 33756-3905
- Fax : (727) 441-5008
- Phone : (727) 441-5044
Second Address
- Dr. Richard Peterkin Wallace
- 1001 S Fort Harrison Ave Suite 101
- Clearwater, FL
- Zip : 33756-3941
- Fax : (727) 441-5008
- Phone : (727) 441-5044
Reviews
FAQs
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Is Dr. Richard Peterkin Wallace a sole practitioner?
Is Dr. Richard Peterkin Wallace accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Q00000X | Family Doctor | ME85690 | FL |
| N | 207QS0010X | Family Doctor - Sports Medicine | ME85690 | FL |
National Provider Identifier
| NPI | 1275586448 |
|---|---|
| Provider Name | Dr. Richard Peterkin Wallace |
| First Address | Clearwater, FL 33756-3905 |
| Second Address | Clearwater, FL 33756-3941 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/05/2006 |
| Last Update Date | 27/09/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 270183900 | (05) | FL |
| H97959 | (02) | |
| P00294408 | RAILROAD MEDICARE NUMBER (01) | FL |
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.