Search › Indiana › 208G00000X
Douglas Wallace, M.D
NPI 1851470033 · on the registry since 2006
Practice
- Address
- 3900 St Francis Way
Ste 201
Lafayette, IN 47905 - Phone
- (765) 446-7981
- Fax
- (765) 446-7982
- Organisation at this address
- Unity Healthcare Llc
Lafayette Vein And Vascular Center LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 36
Registry record
- Primary taxonomy
- 208G00000X
208G00000X
- Also registered as
- 208G00000X
208G00000X - Licence states on file
- CA, IL, IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-12-19
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 Indiana