DR. DOUGLAS WALLACE (NPI# 1285098806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285098806 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS WALLACE |
| Credential | M.D. |
| Practice Address |
625 19th St S Birmingham AL 35233 |
| Mailing Address |
625 19th St S Birmingham AL 35233-1900 |
| Practice Telephone | 2059757387 |
| Mailing Telephone | 2059757387 |
| Enumeration Date | 2016-04-09 |
| Last Update Date | 2018-08-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 36768 | AL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376698753 | Douglas W. Wallace | Oral & Maxillofacial Surgery | 5188 Winton Rd, Fairfield, OH 45014-2900 | 2007-01-24 |
| 1063451144 | Douglas C Wallace | Family Medicine | 3154 Park St, Grove City, OH 43123-3222 | 2006-06-05 |
| 1730794041 | Douglas Wallace | Hearing Instrument Specialist | 95 Post Office Park, Wilbraham, MA 01095-1248 | 2020-09-14 |
| 1811181498 | Douglas Cecil Wallace | Medical Genetics, Ph.D. Medical Genetics | 2014 Hewitt Hall, University of California Irvine, Irvine, CA 92697-3940 | 2007-08-28 |
| 1013058932 | Douglas Mckay Wallace | Psychiatry & Neurology | 1201 Nw 16th St, Miami Va Medical Center, Dept of Neurology, Miami, FL 33125-1624 | 2007-02-12 |
| 1851470033 | Douglas Charles Wallace | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3900 St Francis Way, Ste 201, Lafayette, IN 47905-4923 | 2006-11-06 |
| 1881657989 | Douglas M Wallace | Emergency Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2006-04-10 |
| 1083608053 | Douglas W Wallace | Radiology | 2300 Manchester Expy, Ste A001, Columbus, GA 31904-6802 | 2005-09-07 |
| Street Address |
625 19TH ST S |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992835854 | Niambi Ashaki Horton | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35249-1712 | 2007-03-07 |
| 1104426998 | Mohamed Morsy Mohamed Morsy | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2020-10-29 |
| 1861008146 | Ahsan Raza | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2020-09-21 |
| 1700494200 | Sankalp Arora | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2020-07-21 |
| 1669080164 | Maria Gabriela Gastanadui Gonzalez | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2020-07-21 |
| 1861000432 | Hrishikesh Dadhich | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2020-07-20 |
| 1700494697 | Sanjith Prahas Krishnam | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2020-07-16 |
| 1457973075 | Joseph Michael Cortopassi Jr. | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2020-05-18 |
| 1255953360 | Timothy Graham Norwood | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2020-05-12 |
| 1538780341 | Igor Damasceno Vidal | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2020-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821605700 | Motivity Chiropractic | Chiropractor | 2413 2nd Avenue South, Ste 100, Birmingham, AL 35233 | 2020-09-25 |
| 1477164580 | Rebecca Diane Davis | Physician Assistant | 701 S. 19th St, Lhr 112, Birmingham, AL 35233 | 2020-08-12 |
| 1972136794 | Faleh Ali Alshanhrani | Student in an Organized Health Care Education/Training Program | Children's of Alabama, 1600 7th Ave South, Birmingham, AL 35233 | 2020-02-20 |
| 1972149128 | Jessica Lynne Miller | Registered Nurse | 1816 6th Ave South, Birmingham, AL 35233 | 2019-11-22 |
| 1881156404 | Chalandra Barley | Registered Nurse | 1802 6th Ave S., 7th Floor Sicu, Birmingham, AL 35233 | 2019-04-02 |
| 1255893004 | Mia Weitman Neustein | Registered Nurse | Uab Wic -- Gynx, 1700 6th Avenue South, Birmingham, AL 35233 | 2019-04-02 |
| 1457813214 | Tabrisha Love | Registered Nurse | Uab University Hospital 1802 6th Ave S, Birmingham, AL 35233 | 2019-04-02 |
| 1356809602 | Catherine Mary Verga | Occupational Therapist | 1600 7th Ave. S., Mcwane Building Pt/ot Department, Birmingham, AL 35233 | 2019-03-06 |
| 1649736752 | Proton International Alabama, LLC | Clinic/Center | 400 20th Street South, Birmingham, AL 35233 | 2019-02-13 |
| 1447728910 | Eric Jackson | Specialist/Technologist | 1219 6th Ave S, Birmingham, AL 35233 | 2018-11-02 |
| Find all providers in zip 35233 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245768316 | Ashton Elisabeth Kilgore | Emergency Medicine | 618 20th St South Suite 251, Birmingham, AL 35249-4756 | 2017-06-01 |
| 1568998169 | Hannah Obayangban | Emergency Medicine | 801 Princeton Ave Sw Ste 101, Birmingham, AL 35211-1306 | 2017-05-03 |
| 1831518943 | Rene Thomas Schexnaildre Jr. | Emergency Medicine | 7191 Cahaba Valley Rd Ste 108, Birmingham, AL 35242-6461 | 2014-04-16 |
| 1205197951 | Northwest Emergency Physician Group | Emergency Medicine | 624 28th St N, Birmingham, AL 35203 | 2012-05-30 |
| 1952690950 | Christina Helen Cooley | Emergency Medicine | 619 19th St N, Birmingham, AL 35249-0001 | 2011-03-31 |
| 1013236975 | Elizabeth Holcombe Adams | Emergency Medicine | 218 Devon Dr, Birmingham, AL 35209 | 2010-05-18 |
| 1982838181 | William F Rushton | Emergency Medicine | 619 19th St S # 251, Birmingham, AL 35249-7013 | 2009-05-04 |
| 1295977346 | Timothy Scott Turner | Emergency Medicine | 810 St Vincents Birmingham Dr, Birmingham, AL 35205 | 2009-04-02 |
| 1174779003 | Nicole Eleana Jones | Emergency Medicine | 1600 7th Ave S Ste 110, Birmingham, AL 35233-1711 | 2008-08-12 |
| 1124228911 | Jenna Lynn Johnson | Emergency Medicine | 1041 Ashmore Ln, Birmingham, AL 35242-2464 | 2007-07-20 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35233 |
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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.