Individual
MICHAEL TAYLOR WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
994 DREW LN, AUBURN, AL 36830-4302
(334) 364-3330
Mailing address
994 DREW LN, AUBURN, AL 36830-4302
(334) 364-3330
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
41653
AL
207W00000X
Ophthalmology Physician
59163
TN
Other
Enumeration date
05/28/2015
Last updated
12/30/2025
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