WALLACE MCCLURE (NPI# 1407266653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407266653 |
| Entity Type | Individual |
| Full Name | WALLACE MCCLURE |
| Credential | M.D. |
| Practice Address |
450 Powers Blvd. Waverly TN 37185 |
| Practice Telephone | 9312962054 |
| Mailing Telephone | 9312962054 |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2014-04-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | MD4230 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
450 POWERS BLVD. |
| City | WAVERLY |
| State | TN |
| Zip Code | 37185 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104295567 | Tiffany Szabo | Speech-Language Pathologist | 670 Tn- 13, Waverly, TN 37185 | 2015-09-16 |
| 1982995346 | Laurel Lea Barrier | Speech-Language Pathologist | 1171 Lockhart Road, Waverly, TN 37185 | 2011-04-20 |
| 1477703155 | Christie Madge King-patterson | Nurse Practitioner | 215b Holly Lane, Waverly, TN 37185 | 2008-09-30 |
| 1396921946 | Tammy Jo Saffel | Counselor | 205b East Main Street, Waverly, TN 37185 | 2008-01-14 |
| 1386794816 | Lawrence Richard Jackson Jr. | Family Medicine | 102 Hillwood Dr, Waverly, TN 37185 | 2007-01-10 |
| 1720147119 | Kelley M Blackwell | Marriage & Family Therapist | 795 Holly Ln, Waverly, TN 37185 | 2006-12-08 |
| 1063509578 | Ida Suellen Westerman | Counselor | 205 B East Main Street, Waverly, TN 37185 | 2006-10-06 |
| 1801835962 | Noel R Dominguez | Internal Medicine | 209 West Main Street, Waverly, TN 37185 | 2006-06-05 |
| 1730145822 | Waverly Health Care and Rehabilitation Center Inc | Skilled Nursing Facility | 895 Powers Blvd, Waverly, TN 37185 | 2006-04-26 |
| 1417930231 | Air Evac Ems Inc | Ambulance | 336 Highway 13 S, Waverly, TN 37185 | 2005-11-25 |
| Find all providers in zip 37185 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992923825 | Benjamin Tabiolo Ulep | General Practice | Sussex II State Prison, 24427 Musselwhite Dr, Waverly, VA 23891-0001 | 2007-04-23 |
| 1457435851 | Kenneth A Wilkinson | General Practice | 207 St Anns Ln, Waverly, OH 45690-1040 | 2006-10-24 |
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| 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.