Individual
DR. THOMAS WITHERSPOON WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10100 KANIS RD, LITTLE ROCK, AR 72205-6202
(501) 255-6000
(501) 255-6400
Mailing address
1807 SHADOW LN, LITTLE ROCK, AR 72207-2015
(501) 747-2124
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
E-6988
AR
Other
Enumeration date
11/13/2006
Last updated
06/21/2016
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