WALLACE FORD MARTIN (NPI# 1487651386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487651386 |
| Entity Type | Individual |
| Full Name | WALLACE FORD MARTIN |
| Credential | MD |
| Practice Address |
631 Professional Drive Suite 300 Lawrenceville GA 30046-3371 |
| Practice Telephone | 7709629977 |
| Practice Fax Number | 7703399804 |
| Mailing Telephone | 7709629977 |
| Mailing Fax Number | 7703399804 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2010-09-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 026153 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00301914A | 05 | |
| GA | MEDICARE GROUP NUMBER | GRP1797 | 01 |
| Street Address |
631 PROFESSIONAL DRIVE SUITE 300 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30046-3371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003041104 | Barbara O'callaghan | Registered Nurse | 631 Professional Drive, 450, Lawrenceville, GA 30046-7651 | 2009-05-19 |
| 1861627028 | Theresa Lynn Catlin | Registered Nurse | 631 Professional Drive, Suite 450, Lawrenceville, GA 30046-7651 | 2009-05-18 |
| 1902003841 | Charles B Moomey Jr Md | Surgery | 631 Professional Drive, Suite 300, Lawrenceville, GA 30046-3371 | 2007-07-02 |
| 1639226178 | John A. Chandler | Physician Assistant | 631 Professional Drive, Suite 200, Lawrenceville, GA 30046-3367 | 2007-01-05 |
| 1710049036 | Gwinnett Consultants In Cardiology | Specialist | 631 Professional Drive, Ste 360, Lawrenceville, GA 30046-0000 | 2006-12-14 |
| 1508926759 | Suburban Hematology Oncology Associates, PC | Internal Medicine | 631 Professional Drive, Suite 450, Lawrenceville, GA 30046-7651 | 2006-12-11 |
| 1659460244 | Christopher T Hagenstad | Internal Medicine | 631 Professional Drive, Ste 210, Lawrenceville, GA 30046 | 2006-10-12 |
| 1821187436 | Anthony M Landis | Internal Medicine | 631 Professional Drive, Suite 450, Lawrenceville, GA 30046-7651 | 2006-10-12 |
| 1073602751 | Alexander Saker Jr. | Internal Medicine | 631 Professional Drive, Suite 450, Lawrenceville, GA 30046 | 2006-10-12 |
| 1114969052 | Satvir Singh | Internal Medicine | 631 Professional Drive, Suite 450, Lawrenceville, GA 30046-7651 | 2006-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063023174 | Alpha & Omega Hearing Centers | Hearing Instrument Specialist | Alpha & Omega Hearing Centers, 250 Langley Drive, Suite 1106, Lawrenceville, GA 30046 | 2020-08-12 |
| 1285259846 | Mesun Health Services, Inc | Clinical Nurse Specialist | 88 Johnson Rd Building # 1-b, Lawrenceville, GA 30046 | 2020-06-10 |
| 1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
| 1306499785 | Bryan Acosta | Chiropractor | 471 Scenic Hwy South, Lawrenceville, GA 30046 | 2019-07-24 |
| 1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
| 1548730179 | Alexis Nicole Robinson | Nurse Anesthetist, Certified Registered | 1000 Medical Center Boulevard, Lawrenceville, GA 30046 | 2018-11-27 |
| 1679060388 | Christopher Puckett | Student in an Organized Health Care Education/Training Program | 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 | 2018-04-18 |
| 1457851255 | Advanced Urology Institute of Georgia | Urology | 501 Crown Point Way, Lawrenceville, GA 30046 | 2018-02-19 |
| 1013447044 | Pharmacy Investments of Lawrenceville, LLC | Pharmacy | 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 | 2017-06-13 |
| 1225577000 | Priority Housecalls LLC | Clinic/Center | 225 Scenic Hwy, Ste 200, Lawrenceville, GA 30046 | 2017-02-14 |
| Find all providers in zip 30046 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306239017 | Georgia Hill | Surgery | 631 Professional Dr Ste 470, Lawrenceville, GA 30046-3370 | 2015-03-05 |
| 1992865463 | F.enrique Alvarez Md | Surgery | 123 Franklin Corner Rd Ste 204, Lawrenceville, NJ 08648-2526 | 2006-12-12 |
| 1497855779 | Kevin Lee Jensen | Surgery | 743 Old Norcross Rd, Lawrenceville, GA 30046-4317 | 2006-09-25 |
| 1174583470 | Suraj Jose Menachery | Surgery | 631 Professional Dr Ste 300, Lawrenceville, GA 30046-3371 | 2006-03-23 |
| 1679136824 | Northside Gwinnett Surgical Associates, LLC | Surgery | 631 Professional Dr Ste 300, Lawrenceville, GA 30046-3371 | 2019-04-15 |
| 1972918050 | Georgia Breast Surgery PC | Surgery | 631 Professional Dr, Suite 240, Lawrenceville, GA 30046-3367 | 2014-06-26 |
| 1205105731 | Jessica Reynolds | Surgery | 631 Professional Dr Ste 300, Lawrenceville, GA 30046-3371 | 2011-12-29 |
| 1396049383 | Gwinnett Surgical Associates, LLP | Surgery | 631 Professional Dr, Suite 300, Lawrenceville, GA 30046-3367 | 2011-01-05 |
| 1154653590 | Dr. Stephen Quill, Md, PC | Surgery | 771 Old Norcross Rd, Suite 300, Lawrenceville, GA 30046-4386 | 2010-02-10 |
| 1134370711 | Luttrell L Toussaint | Surgery | 1000 Medical Center Blvd, Lawrenceville, GA 30046-7694 | 2008-10-01 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30046 |
Please comment or provide details below to improve the information on WALLACE FORD MARTIN.
| 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.