WALLACE LOCK

FORT SMITH, AR
NPI1437545761
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207P00000X Emergency Medicine
(Licence: TN  67669)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: AR  E-10064)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2015-04-14
Last Update Date2024-04-04
Business Address
WALLACE LOCK M.D.
612 S 12TH ST
FORT SMITH, AR 72901-4702
Phone number: 479-424-3193
Mailing Address
WALLACE LOCK M.D.
111 N 1ST ST
HUGHES, AR 72348-9100
Phone number: 901-481-0927