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Individual

DR. HAROLD JAMES WALLACE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
111 COLCHESTER AVE, FLETCHER ALLEN HEALTH CARE DEPT. OF RADIATION ONCOLOGY, BURLINGTON, VT 05401-1473
(802) 847-3506
(802) 847-2386
Mailing address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(800) 847-0000

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
042-0009975
VT
2085R0001X
Radiation Oncology Physician
308258
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
OVN2161
VT
Enumeration date
07/22/2006
Last updated
07/25/2025
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