Individual
DR. AUSTIN FISHER WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1010 THREE SPRINGS BLVD, SUITE 294, DURANGO, CO 81301-8296
(970) 247-4311
(970) 764-3894
Mailing address
1010 THREE SPRINGS BLVD, SUITE 294, DURANGO, CO 81301-8296
(970) 247-4311
(970) 764-3894
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
7087070-1205
UT
207L00000X
Anesthesiology Physician
Primary
DR.0053508
CO
207R00000X
Internal Medicine Physician
MDR-5299
HI
Other
Enumeration date
06/27/2007
Last updated
10/08/2024
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