Individual
WALLACE DALE PROPHET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 HERITAGE WAY, SUITE 2100, KALISPELL, MT 59901-3158
(406) 257-8992
(406) 755-4161
Mailing address
350 HERITAGE WAY, SUITE 2100, KALISPELL, MT 59901-3158
(406) 257-8992
(406) 755-4161
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
49643
MT
207RP1001X
Pulmonary Disease Physician
9734
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000012909
—
AL
05
—
00284468A
—
GA
05
—
068414700
—
FL
Enumeration date
09/09/2005
Last updated
08/22/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us