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1174537708
JOHN M. WALLACE
LAUREL, MS
NPI
1174537708
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RP1001X Internal Medicine, Pulmonary Disease
(Licence: MS 08491)
Enumeration Date
2006-07-28
Last Update Date
2013-07-11
Business Address
-- JOHN M. WALLACE M.D.
1203 JEFFERSON ST
LAUREL, MS 39440-4354
Phone number: 601-649-2863
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Mailing Address
-- JOHN M. WALLACE M.D.
1203 JEFFERSON ST
LAUREL, MS 39440-4354
Phone number: 601-649-2863
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