Kenneth A. Wallace III, MD

MOHS-Micrographic Surgery Physician · Ocala, FL

Individual Active NPI

NPI number 1295791754

Practice location

1091 SE 59TH St
Ocala, FL 34480-6146
Phone
(850) 597-0324

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NPI record

NPI
1295791754
Entity type
Individual (Type 1)
Enumeration date
April 25, 2006
Last updated
April 2, 2020
Certified
April 2, 2020
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
MOHS-Micrographic Surgery Physician Primary 207ND0101X ME73625 FL
Dermatology Physician 207N00000X ME73625 FL
Procedural Dermatology Physician 207NS0135X ME73625 FL

About Dr. Wallace

Kenneth A. Wallace III, MD is a healthcare provider registered in the NPI registry with the primary taxonomy MOHS-Micrographic Surgery Physician (code 207ND0101X). The practice location is 1091 SE 59TH St, Ocala, FL 34480-6146. The NPI number 1295791754 was assigned on April 25, 2006 and the record was last updated on April 2, 2020.

Dr. Wallace lists 3 licenses in the registry: #ME73625 (FL) for MOHS-Micrographic Surgery Physician; #ME73625 (FL) for Dermatology Physician; #ME73625 (FL) for Procedural Dermatology Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kenneth A. Wallace III, MD?

The NPI number is 1295791754.

What is the phone number of Dr. Wallace?

The phone number listed for the practice location is (850) 597-0324.

Where is Dr. Wallace located?

1091 SE 59TH St, Ocala, FL 34480-6146.

What is the taxonomy code for Dr. Wallace?

The primary taxonomy code is 207ND0101X – MOHS-Micrographic Surgery Physician; 2 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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