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Scott Earl Wallace, DO
Student in an Organized Health Care Education/Training Program in Athens, Ohio
NPI 1861074635

Scott Earl Wallace is a Student in an Organized Health Care Education/Training Program based in Williamstown, OH. Scott Earl Wallace practices in Athens, OH and has the professional credentials of DO. The NPI Number for Scott Earl Wallace is 1861074635 and holds a License No. (Ohio).

The current practice location address for Scott Earl Wallace is 26 Hospital Dr Fl 2, Athens, OH and can be reached out via phone at 740-249-4122 and via fax at 740-249-4126. You can also correspond with Scott Earl Wallace through the mailing address at 106 N ELM ST, WILLIAMSTOWN, WV - 26187-1826 (mailing address contact number: 435-590-0835).

Location: 26 Hospital Dr Fl 2, Athens, OH, 26187-1826
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1861074635
Provider Name
Scott Earl Wallace
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
26 Hospital Dr Fl 2, Athens, OH, 26187-1826
Phone Number
740-249-4122
Fax Number
740-249-4126
Provider Enumeration Date
04/22/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
26 Hospital Dr Fl 2
City
Athens
State
Ohio
Zip
45701-2471
Phone Number
740-249-4122
Fax Number
740-249-4126
person
Provider Business Mailing Address Details
Address
26 Hospital Dr Fl 2
City
Athens
State
Ohio
Zip
45701-2471
Phone Number
740-249-4122
Fax Number
740-249-4126
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
34.016172 (Ohio)
Definition
Definition to come...
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.
()
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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