Individual
DR. DAVID JOSEPH WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
979 E 3RD ST STE C-290, CHATTANOOGA, TN 37403-2136
(423) 265-2233
(423) 756-8265
Mailing address
979 E 3RD ST STE C-290, CHATTANOOGA, TN 37403-2136
(423) 265-2233
(423) 756-8265
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
125062133
IL
207T00000X
Neurological Surgery Physician
Primary
61102
TN
390200000X
Student in an Organized Health Care Education/Training Program
BP10054957
TX
Other
Enumeration date
06/26/2012
Last updated
02/12/2021
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