William David Wallace, MD - Jackson, MS

William David Wallace, MD

Student in an Organized Health Care Education/Training Program in Jackson, Mississippi

NPI 1679060438

William David Wallace is a Student in an Organized Health Care Education/Training Program based in Jackson, MS. William David Wallace practices in Jackson, MS and has the professional credentials of MD. The NPI Number for William David Wallace is 1679060438 and holds a License No. (Mississippi).

The current practice location address for William David Wallace is 2500 N State St, Jackson, MS and can be reached out via phone at 601-815-1779 and via fax at 601-815-0444.

Location: 2500 N State St, Jackson, MS, 39216-4500

NPI Number

1679060438

Provider Name

William David Wallace

Credential

Provider Entity Type

Individual

Gender

Male

Address

2500 N State St, Jackson, MS, 39216-4500

Phone Number

601-815-1779

Fax Number

601-815-0444

Provider Enumeration Date

04/17/2018

Last Update Date

03/10/2024

Address

2500 N State St

City

Jackson

State

Mississippi

Zip

39216-4500

Phone Number

601-815-1779

Fax Number

601-815-0444

Address

2500 N State St

City

Jackson

State

Mississippi

Zip

39216-4500

Phone Number

601-815-1779

Fax Number

601-815-0444

Type

Student, Health Care

Classification

Student in an Organized Health Care Education/Training Program

Speciality

Taxonomy

390200000X

License No.

()

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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