Individual
BARRETT JEFFREY WALLIS
Active
Individual
BARRETT JEFFREY WALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
35.088718
OH
207RG0100X
Gastroenterology Physician
Primary
ME48685
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001690000
—
FL
01
—
12042524
MULTIPLAN
NY
01
—
1299092
GHI GROUP HEALTH INC
NY
01
—
146VV
BCBS OF FLORIDA
FL
01
—
333619
AVMED
FL
Enumeration date
06/07/2006
Last updated
10/10/2024
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