Individual
DR. LAILUN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5227 E CAREFREE HWY, CAVE CREEK, AZ 85331-9173
(602) 824-3900
Mailing address
13677 W MCDOWELL RD, GOODYEAR, AZ 85395-2635
(718) 308-6075
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301093013
MI
Other
Enumeration date
07/24/2008
Last updated
12/21/2023
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