Individual
DEBORAH I WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3840 RUCKRIEGEL PKWY, SUITE 105, LOUISVILLE, KY 40299-6835
(502) 261-7227
(844) 965-9615
Mailing address
3840 RUCKRIEGEL PKWY, SUITE 105, LOUISVILLE, KY 40299-6835
(502) 261-7227
(844) 965-9615
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
39992
KY
Other
Enumeration date
07/03/2006
Last updated
01/28/2021
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