Individual
RANDY LAMAR WALLACE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 WABASH AVE, AKRON, OH 44307-2433
(330) 344-6000
Mailing address
1 AKRON GENERAL AVE, AKRON, OH 44307-2432
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35126112
OH
Other
Enumeration date
04/30/2012
Last updated
03/07/2016
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