Individual
DR. WILLIAM ARTHUR WALLACE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1679 EAGLE HARBOR PKWY, SUITE C, FLEMING ISLAND, FL 32003-4815
(904) 348-0727
(904) 621-9272
Mailing address
1679 EAGLE HARBOR PKWY, SUITE C, FLEMING ISLAND, FL 32003-4815
(904) 348-0727
(904) 621-9272
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
35.079632
OH
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
ME107749
FL
Other
Enumeration date
04/22/2007
Last updated
11/01/2015
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