person
Dr. Michael Robert Wallace, DPM
Foot & Ankle Surgery Podiatrist in Valdosta, Georgia
NPI 1295828416

Michael Robert Wallace is a Foot & Ankle Surgery Podiatrist based in Valdosta, GA and is specialized in Foot & Ankle Surgery. Michael Robert Wallace practices in Valdosta, GA and has the professional credentials of DPM. The NPI Number for Michael Robert Wallace is 1295828416 and holds a License No. 599 (Georgia).

The current practice location address for Michael Robert Wallace is 2800 N Oak St, Valdosta, GA and can be reached out via phone at 229-244-1211 and via fax at 229-244-2721. You can also correspond with Michael Robert Wallace through the mailing address at 2800 N OAK ST, VALDOSTA, GA - 31602-1716 (mailing address contact number: 229-244-1211).

Location: 2800 N Oak St, Valdosta, GA, 31602-1716
person
Provider Profile Details
NPI Number
1295828416
Provider Name
Michael Robert Wallace
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
2800 N Oak St, Valdosta, GA, 31602-1716
Phone Number
229-244-1211
Fax Number
229-244-2721
Provider Enumeration Date
10/02/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000480029131 05 GA
institution
Provider Business Practice Location Address Details
Address
2800 N Oak St
City
State
Zip
31602-1716
Phone Number
229-244-1211
Fax Number
229-244-2721
person
Provider Business Mailing Address Details
Address
2800 N Oak St
City
State
Zip
31602-1716
Phone Number
229-244-1211
Fax Number
229-244-2721
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
599 (Georgia)
Definition
Definition to come...
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