Dr. Thomas Witherspoon Wallace
Clinical Cardiac Electrophysiologist
10100 Kanis Rd
Little Rock
, Arkansas 72205-6202
Dr. Thomas Witherspoon Wallace
Clinical Cardiac Electrophysiologist
10100 Kanis Rd
Little Rock
, Arkansas 72205-6202
(501) 747-2124
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About
Features
Specialties
- Clinical Cardiac Electrophysiologist
Languages spoken
- English
Location
First Address
- Dr. Thomas Witherspoon Wallace
- 1807 Shadow Ln
- Little Rock, AR
- Zip : 72207-2015
- Phone : (501) 747-2124
Second Address
- Dr. Thomas Witherspoon Wallace
- 10100 Kanis Rd
- Little Rock, AR
- Zip : 72205-6202
- Fax : (501) 255-6400
- Phone : (501) 255-6000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RC0001X | Clinical Cardiac Electrophysiologist | E-6988 | AR |
National Provider Identifier
| NPI | 1295807733 |
|---|---|
| Provider Name | Dr. Thomas Witherspoon Wallace |
| First Address | Little Rock, AR 72207-2015 |
| Second Address | Little Rock, AR 72205-6202 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/11/2006 |
| Last Update Date | 21/06/2016 |
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.