Individual
DR. AUSTIN WILLIAM WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 E DERENNE AVE, SAVANNAH, GA 31405-6736
(912) 644-5300
Mailing address
210 E DERENNE AVE, SAVANNAH, GA 31405-6736
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
ME163050
FL
207XX0801X
Orthopaedic Trauma Physician
Primary
101390
GA
207XX0801X
Orthopaedic Trauma Physician
ME163050
FL
Other
Enumeration date
05/05/2018
Last updated
02/10/2025
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