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1730591017
JERALD PAYDEN WALLACE
LEXINGTON, KY
NPI
1730591017
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208600000X Surgery
(Licence: KY 49437)
Enumeration Date
2014-05-21
Last Update Date
2016-07-07
Business Address
-- JERALD PAYDEN WALLACE M.D.
800 ROSE ST C246
LEXINGTON, KY 40536-0293
Phone number: 859-323-6162
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Mailing Address
-- JERALD PAYDEN WALLACE M.D.
800 ROSE ST C246
LEXINGTON, KY 40536-0293
Phone number: 859-323-6162
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