person
Catherine Wallace, MD
General Practice Physician in Dallas, Georgia
NPI 1154946606

Catherine Wallace is a General Practice Physician based in Dallas, GA. Catherine Wallace practices in Dallas, GA and has the professional credentials of MD. The NPI Number for Catherine Wallace is 1154946606 and holds a License No. 94669 (Georgia).

The current practice location address for Catherine Wallace is 243 Merchants Dr, Dallas, GA and can be reached out via phone at 770-230-9967 and via fax at 770-445-5860.

Location: 243 Merchants Dr, Dallas, GA, 30132-4749
person
Provider Profile Details
NPI Number
1154946606
Provider Name
Catherine Wallace
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
243 Merchants Dr, Dallas, GA, 30132-4749
Phone Number
770-230-9967
Fax Number
770-445-5860
Provider Enumeration Date
06/10/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8101560001 01 GA DME MAC JURISDICTION C
institution
Provider Business Practice Location Address Details
Address
243 Merchants Dr
City
State
Zip
30132-4700
Phone Number
770-230-9967
Fax Number
770-445-5860
person
Provider Business Mailing Address Details
Address
243 Merchants Dr
City
State
Zip
30132-4700
Phone Number
770-230-9967
Fax Number
770-445-5860
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
94669 (Georgia)
Definition
Definition to come...
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