Individual
HENRY C. WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2526 HIGHWAY 65 S STE 205, CLINTON, AR 72031-6678
(501) 500-3500
Mailing address
800 FAIR PARK BLVD, LITTLE ROCK, AR 72204-1720
(501) 404-8007
(501) 904-3620
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
N4831
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188382001
—
AR
01
—
1922327485
NPI
AR
Enumeration date
05/24/2010
Last updated
06/01/2026
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