Individual
DR. RICHARD B WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1504 SPRING HILL AVE, MOBILE, AL 36604-3207
(251) 219-3900
Mailing address
75 GENERAL CANBY DR, SPANISH FORT, AL 36527-8005
(251) 625-6226
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
014847
LA
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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