Organization
STEPHEN A. WALLACE, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY L WALLACE (OFFICE ADMINISTRATOR)
(928) 726-0985
Entity
Organization
Contact information
Practice address
2741 S 8TH AVE, SUITE C, YUMA, AZ 85364-7154
(928) 726-0985
(928) 726-9395
Mailing address
2741 S 8TH AVE, SUITE C, YUMA, AZ 85364-7154
(928) 726-0985
(928) 726-9395
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
13856
AZ
Other
Enumeration date
11/17/2009
Last updated
11/17/2009
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