DR. DAVID L. WALLACE (NPI# 1194725929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194725929 |
| Entity Type | Individual |
| Full Name | DR. DAVID L. WALLACE |
| Credential | M.D. |
| Practice Address |
2600 E Southern Ave Suite H-1 Tempe AZ 85282-7610 |
| Mailing Address |
2600 E Southern Ave Suite F-4 Tempe AZ 85282-7610 |
| Practice Telephone | 4803452488 |
| Practice Fax Number | 4808319926 |
| Mailing Telephone | 4808383035 |
| Mailing Fax Number | 4808386377 |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 173000000X | Legal Medicine | 6580 | AZ | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | DES | 255572 | 01 |
| AZ | UNITED HEALTHCARE | 0100130 | 01 |
| AZ | CIGNA HEALTHCARE | 1078601 | 01 |
| AZ | ICA | 21076580 | 01 |
| AZ | FAA AME SERIAL | 134711 | 01 |
| AZ | BLUE CROSS/BLUE SHIELD | AZ0361150 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700327061 | David Wallace | Student in an Organized Health Care Education/Training Program | 24606 Mosquero Ln, Mission Viejo, CA 92691-4913 | 2017-03-19 |
| 1265743595 | David R Wallace Jr. | Radiology | 200 W Arbor Dr # Mc0834, Department of Radiology, San Diego, CA 92102-0834 | 2010-07-01 |
| 1386868487 | David Stuart Wallace | Chiropractor | 2330 Highway 94 South Outer Rd, Saint Charles, MO 63303-8301 | 2007-04-12 |
| 1649343641 | David Michael Wallace | Chiropractor | 112 W Grand Ave, Rainbow City, AL 35906-3233 | 2006-11-16 |
| 1932193604 | David Wallace | Anesthesiology | 738 Golden Pheasant Dr, Draper, UT 84020-8454 | 2005-09-08 |
| 1386646206 | David Allen Wallace | Dentist | 206 S Walker St, Princeton, WV 24740-2747 | 2005-08-11 |
| 1295736809 | David B. Wallace | Radiology | 325 N Highland Ave, Provena Mercy Medical Center, Aurora, IL 60506-3811 | 2005-08-04 |
| 1679576276 | David Alan Wallace | Ophthalmology | 11600 Wilshire Blvd, Ste 200, Los Angeles, CA 90025-1782 | 2005-05-27 |
| 1619596335 | David Alexander Wallace | Student in an Organized Health Care Education/Training Program | 920 Madison Ave Ste 447, Memphis, TN 38103-3438 | 2020-04-13 |
| 1396364402 | David Carter Wallace | Student in an Organized Health Care Education/Training Program | 620 Shadow Ln, Las Vegas, NV 89106-4119 | 2020-04-09 |
| Street Address |
2600 E SOUTHERN AVE SUITE H-1 |
| City | TEMPE |
| State | AZ |
| Zip Code | 85282-7610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174525448 | John Grant Fletcher | Dentist | 2600 E Southern Ave, Ste B1, Tempe, AZ 85282-7745 | 2005-06-01 |
| 1508220443 | La Vereda Medical Center | Family Medicine | 2600 E Southern Ave, Suite G, Tempe, AZ 85282-7610 | 2016-04-06 |
| 1912386137 | Corey Skubisz | Naturopath | 2600 E Southern Ave, Suite G, Tempe, AZ 85282 | 2015-05-20 |
| 1003211921 | Skycrest Neurology, Pllc | Psychiatry & Neurology | 2600 E Southern Ave, #d1, Tempe, AZ 85282-7610 | 2014-11-04 |
| 1316375801 | Banner Health | Non-Pharmacy Dispensing Site | 2600 E Southern Ave, Suite B2, Tempe, AZ 85282-7610 | 2013-10-22 |
| 1710225057 | Sunstate Cardiology PC | Internal Medicine | 2600 E Southern Ave, Building I Suite 1, Tempe, AZ 85282-7610 | 2013-01-22 |
| 1780928051 | Adolph Silberman, Ed.d.p.c. | Psychologist | 2600 E Southern Ave, Suite C-3, Tempe, AZ 85282-7610 | 2012-11-26 |
| 1629321302 | Carolyn B Pace Md PC | Clinic/Center | 2600 E Southern Ave, Suite K, Tempe, AZ 85282-7610 | 2012-10-18 |
| 1164715751 | Natasa Vojvodic | Family Medicine | 2600 E Southern Ave, B2, Tempe, AZ 85282-7610 | 2011-05-16 |
| 1932406105 | East Valley Pulmonary Associates | Internal Medicine | 2600 E Southern Ave, Ste I-3, Tempe, AZ 85282-7610 | 2011-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346893575 | Cactus Canyon Dental | Dentist | 2043 E Southern Ave, Ste. C, Tempe, AZ 85282 | 2019-07-17 |
| 1023679644 | Donna Cooks | Registered Nurse | 233 E. Sourthern Ave #27702, Tempe, AZ 85282 | 2019-06-25 |
| 1841854932 | Lynn Stafford | Registered Nurse | 4041 S. Mcclintock, Ste 302, Tempe, AZ 85282 | 2019-04-24 |
| 1598227340 | Jane Ramenofsky Ramenofsky Stewart | Registered Nurse | 4041 So. Mcclintock Suite 302, Tempe, AZ 85282 | 2019-04-02 |
| 1588129902 | Mary K Wheeler Mcfarland | Registered Nurse | Adobe Care and Wellness LLC, Address Is 4041 S. Mcclintock, Ste 302, Tempe, AZ 85282 | 2019-02-11 |
| 1669949780 | Crestview Pharmacy Services LLC | Pharmacy | 3225 South Hardy Dr., Ste 100, Tempe, AZ 85282 | 2018-10-26 |
| 1275018715 | Berlin Wright | Naturopath | 2164 E. Broadway Rd., Tempe, AZ 85282 | 2018-10-01 |
| 1043701543 | Lakeshore Interventional Treatment Center LLC | Surgery | 4765 S Lakeshore Dr, Tempe, AZ 85282 | 2018-05-21 |
| 1427553940 | The Bridge Counseling, Consulting and Mediation LLC | Counselor | 4625 S. Lakeshore Dr., 302, Tempe, AZ 85282 | 2018-03-27 |
| 1346741501 | Coraesthetics Pllc | Physician Assistant | 2008 E Laguna Dr, Tempe, AZ 85282 | 2018-02-23 |
| Find all providers in zip 85282 | ||||
| Taxonomy Code | 173000000X |
| Grouping | Other Service Providers |
| Classification | Legal Medicine |
| The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912930306 | Freddie Carabajal | Legal Medicine | 8701 S Hardy Dr, Tempe, AZ 85284-2800 | 2006-07-08 |
| 1588696298 | John R Omohundro | Legal Medicine | 8701 S Hardy Dr, Tempe, AZ 85284-2800 | 2006-07-06 |
| 1275533192 | Paul E. Reinholtz | Legal Medicine | 2600 E Southern Ave, Suite F-4, Tempe, AZ 85282-7610 | 2005-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659728871 | Alliance Evaluation Services LLC | Legal Medicine | 10586 W Cottontail Ln, Peoria, AZ 85383-9660 | 2016-05-17 |
| 1275803496 | Desert View Pediatrics, Corp | Legal Medicine | 2737 E Sweetwater Ave, Phoenix, AZ 85032-6930 | 2012-01-04 |
| 1639360118 | Nestor N. Nazareno Md PC | Legal Medicine | 14420 W Meeker Blvd Ste 109, Sun City West, AZ 85375-5287 | 2007-08-08 |
| 1326247115 | Vangard Medical Inc | Legal Medicine | 9619 N Hayden Rd, Suite 114, Scottsdale, AZ 85258-5831 | 2007-07-12 |
| 1891847174 | Christina M Shim | Legal Medicine | 19636 N 27th Ave Ste 306, Phoenix, AZ 85027-4019 | 2007-01-17 |
| 1982700514 | Roselavender A. Richards, M.d. P.C. | Legal Medicine | 515 W Buckeye Rd Ste 106, Phoenix, AZ 85003-2648 | 2006-09-14 |
| 1780605618 | Babak M. Nayeri | Legal Medicine | 2899 N 87th St, Suite 110, Scottsdale, AZ 85257-1767 | 2006-07-23 |
| 1689611832 | Petr O Ruzicka | Legal Medicine | 1432 S, Dobson, Suite 403, Mesa, AZ 85202 | 2006-05-31 |
| 1730130022 | Michael Royal Durham | Legal Medicine | 703 E Ash St, Globe, AZ 85501-1865 | 2006-05-12 |
| 1255389052 | Leona Marie Martin | Legal Medicine | 1841 W 25th St, Ste B, Yuma, AZ 85364-6920 | 2006-05-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.