Individual
DR. GARY RHETT WALLACE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D., FAAFP
Contact information
Practice address
BLDG 5-4257, BASTOGNE EXTENSION, FORT BRAGG, NC 28310-0001
(910) 907-9560
(910) 907-9818
Mailing address
2817 REILLY RD, WOMACK ARMY MEDICAL CENTER, FORT BRAGG, NC 28310-7324
(910) 907-8922
(910) 907-6069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J8821
TX
Other
Enumeration date
11/17/2005
Last updated
07/08/2007
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