Organization
MEDICAL IMAGING SHELBYVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID W WALLACE MD, MBA (PRESIDENT)
(502) 647-0311
Entity
Organization
Contact information
Practice address
101 STONECREST RD, SUITE 2, SHELBYVILLE, KY 40065-8169
(502) 647-0311
(502) 647-6011
Mailing address
101 STONECREST RD, SUITE 2, SHELBYVILLE, KY 40065-8169
(502) 647-0311
(502) 647-6011
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
Other
Enumeration date
01/20/2010
Last updated
01/29/2010
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