Individual
DR. RICHARD M. WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
925 HIGHLAND BLVD.,, SUITE 1180, BOZEMAN, MT 59715
(406) 587-8631
(406) 587-1343
Mailing address
925 HIGHLAND BLVD.,, SUITE 1180, BOZEMAN, MT 59715
(406) 587-8631
(406) 587-1343
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6907
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0089427
—
MT
05
—
0144690
—
MT
Enumeration date
04/04/2006
Last updated
07/13/2026
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