Dr. William J Wallace
Facial Plastic Surgeon
5 Sheridan Sq
Kingsport
, Tennessee 37660
Dr. William J Wallace
Facial Plastic Surgeon
5 Sheridan Sq
Kingsport
, Tennessee 37660
(246) 246-8658
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About
Features
Specialties
- Facial Plastic Surgeon
Languages spoken
- English
Location
First Address
- Dr. William J Wallace
- 5 Sheridan Sq
- Kingsport, TN
- Zip : 37660-7390
- Fax : (246) 246-8658
- Phone : (423) 246-8155
Second Address
- Dr. William J Wallace
- 5 Sheridan Sq
- Kingsport, TN
- Zip : 37660
- Fax : (246) 246-8658
- Phone : (423) 246-8155
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YS0123X | Facial Plastic Surgeon | 01428 | TN |
National Provider Identifier
| NPI | 1275539603 |
|---|---|
| Provider Name | Dr. William J Wallace |
| First Address | Kingsport, TN 37660-7390 |
| Second Address | Kingsport, TN 37660 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/06/2005 |
| Last Update Date | 04/06/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 006500391 | (05) | VA |
| 3306857 | (05) | TN |
| 64071962 | (05) | KY |
| F71644 | (02) | TN |
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.