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1306067954
JAMES JEFFERSON WALLACE
MARTINEZ, GA
NPI
1306067954
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: GA 024369)
Enumeration Date
2007-05-01
Last Update Date
2024-06-12
Business Address
JAMES JEFFERSON WALLACE MD
4143 COLUMBIA RD SUITE D
MARTINEZ, GA 30907
Phone number: 706-651-1299
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Mailing Address
JAMES JEFFERSON WALLACE MD
4143 COLUMBIA RD SUITE D
MARTINEZ, GA 30907
Phone number: 706-651-1299
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