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Individual

RICHARD A WALL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
730 MCCULLOCH ST, GLASGOW, VA 24555-2710
(540) 258-1700
(540) 258-1800
Mailing address
PO BOX 388, FISHERSVILLE, VA 22939-0388
(540) 258-1700
(540) 258-1800

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101268996
VA
207Q00000X
Family Medicine Physician
24491
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
244916
SC
Enumeration date
08/16/2005
Last updated
03/13/2025
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