Individual
DR. ROBERT WILLIAM WALLACE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Mailing address
204 N SILVER MAPLE DR, SLIDELL, LA 70458-5483
(504) 554-2131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
326195
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2017
Last updated
04/19/2021
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