Laury M Wallace
Family Doctor - Adult Medicine Family Doctor - Geriatric Medicine Family Doctor - Hospice and Palliative Medicine
16731 Gaither Blvd
Westfield
, Indiana 46074-4607
Laury M Wallace
Family Doctor - Adult Medicine Family Doctor - Geriatric Medicine Family Doctor - Hospice and Palliative Medicine
16731 Gaither Blvd
Westfield
, Indiana 46074-4607
(812) 239-3771
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About
Features
Specialties
- Family Doctor - Adult Medicine
- Family Doctor - Geriatric Medicine
- Family Doctor - Hospice and Palliative Medicine
Languages spoken
- English
Location
First Address
- Laury M Wallace
- 16731 Gaither Blvd
- Westfield, IN
- Zip : 46074-4421
- Phone : (812) 239-3771
Second Address
- Laury M Wallace
- 16731 Gaither Blvd
- Westfield, IN
- Zip : 46074-4607
- Fax : (812) 239-3771
- Phone : (317) 561-6840
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | 71007724A | IN |
| N | 207QG0300X | Family Doctor - Geriatric Medicine | 71007724A | IN |
| N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 71007724A | IN |
National Provider Identifier
| NPI | 1205343845 |
|---|---|
| Provider Name | Laury M Wallace |
| First Address | Westfield, IN 46074-4421 |
| Second Address | Westfield, IN 46074-4607 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/01/2018 |
| Last Update Date | 04/01/2018 |
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.