Individual
DR. RODGER T WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
341 WALLACE RD, SUITE A, NASHVILLE, TN 37211-8000
(615) 834-7744
(615) 834-7786
Mailing address
341 WALLACE RD, SUITE A, NASHVILLE, TN 37211-8000
(615) 834-7744
(615) 834-7786
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD6949
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3419805
—
TN
Enumeration date
08/30/2006
Last updated
07/08/2007
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