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Haily Wallace, MD
Student in an Organized Health Care Education/Training Program in Tucumcari, New Mexico
NPI 1679839534

Haily Wallace is a Student in an Organized Health Care Education/Training Program based in Albuquerque, NM. Haily Wallace practices in Tucumcari, NM and has the professional credentials of MD. The NPI Number for Haily Wallace is 1679839534 and holds a License No. MD2014-0895 (New Mexico).

The current practice location address for Haily Wallace is 402 E Miel De Luna Ave, Tucumcari, NM and can be reached out via phone at 575-461-7100 and via fax at 575-461-7101.

Location: 402 E Miel De Luna Ave, Tucumcari, NM, 87125-6666
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1679839534
Provider Name
Haily Wallace
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
402 E Miel De Luna Ave, Tucumcari, NM, 87125-6666
Phone Number
575-461-7100
Fax Number
575-461-7101
Provider Enumeration Date
04/05/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
402 E Miel De Luna Ave
City
Tucumcari
State
New Mexico
Zip
88401-3828
Phone Number
575-461-7100
Fax Number
575-461-7101
person
Provider Business Mailing Address Details
Address
402 E Miel De Luna Ave
City
Tucumcari
State
New Mexico
Zip
88401-3828
Phone Number
575-461-7100
Fax Number
575-461-7101
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
()
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
MD2014-0895 (New Mexico)
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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