Individual
LINCOLN R WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 KENYON RD, FORT DODGE, IA 50501-5776
(515) 574-6800
Mailing address
24 N 9TH ST, SUITE A, FORT DODGE, IA 50501-3909
(515) 574-6890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34646
IA
Other
Enumeration date
02/02/2006
Last updated
12/22/2016
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