William Arthur Wallace Jr., M.D.

Plastic and Reconstructive Surgery Physician · Fleming Island, FL

Individual Active NPI

NPI number 1184842627

Practice location

1679 Eagle Harbor Pkwy
Suite C
Fleming Island, FL 32003-4815
Phone
(904) 348-0727
Fax
(904) 621-9272

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NPI record

NPI
1184842627
Entity type
Individual (Type 1)
Enumeration date
April 22, 2007
Last updated
November 1, 2015
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Plastic and Reconstructive Surgery Physician Primary 2086S0122X ME107749 FL
Plastic and Reconstructive Surgery Physician 2086S0122X 35.079632 OH

About Dr. Wallace

William Arthur Wallace Jr., M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Plastic and Reconstructive Surgery Physician (code 2086S0122X). The practice location is 1679 Eagle Harbor Pkwy, Suite C, Fleming Island, FL 32003-4815. The NPI number 1184842627 was assigned on April 22, 2007 and the record was last updated on November 1, 2015.

Dr. Wallace lists 2 licenses in the registry: #ME107749 (FL) for Plastic and Reconstructive Surgery Physician; #35.079632 (OH) for Plastic and Reconstructive Surgery Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of William Arthur Wallace Jr., M.D.?

The NPI number is 1184842627.

What is the phone number of Dr. Wallace?

The phone number listed for the practice location is (904) 348-0727.

Where is Dr. Wallace located?

1679 Eagle Harbor Pkwy, Suite C, Fleming Island, FL 32003-4815.

What is the taxonomy code for Dr. Wallace?

The primary taxonomy code is 2086S0122X – Plastic and Reconstructive Surgery Physician; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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