SearchGeorgiaDiagnostic Radiology Physician

Robert Wallace, M.D

NPI 1780015610 · on the registry since 2013 · sole proprietor

Practice

Address
1130 Goat Rock Road
Fortson, GA 31808
Phone
(706) 323-6485
Fax
(706) 596-2025

Registry record

Primary taxonomy
Diagnostic Radiology Physician
2085R0202X
Also registered as
Nuclear Radiology Physician
Diagnostic Ultrasound Physician
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2013-12-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia