Individual
WILLIAM ROBERT WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1601 UNIVERSITY BLVD E, TUSCALOOSA, AL 35404-2920
(205) 349-2273
Mailing address
850 PETER BRYCE BLVD, TUSCALOOSA, AL 35401-7457
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L.5697R
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2022
Last updated
07/16/2024
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