Individual provider · Type 1 NPI

Douglas W. Wallace, MD

Diagnostic Radiology Physician · Columbus, GA

NPI number 1083608053 Active

Practice location

2300 Manchester Expy, Ste A001
Columbus, GA 31904-6802

Call (706) 257-7700 Map

Fax (706) 257-7708

Mailing address

P.o. Box 9145
Columbus, GA 31908-9145

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician 2085R0202X14966 (GA)
Diagnostic Radiology Physician Primary 2085R0202X014966 (GA)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1083608053

Douglas W. Wallace, MD's National Provider Identifier is 1083608053, issued on Sep 7, 2005. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Columbus, GA. The record was last updated on Jul 27, 2015.