FELDER E WALLACE (NPI# 1508014176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508014176 |
| Entity Type | Individual |
| Full Name | FELDER E WALLACE |
| Credential | D.D.S. |
| Practice Address |
6194 Hwy 98 West Hattiesburg MS 39402 |
| Practice Telephone | 6012645756 |
| Practice Fax Number | 6012645013 |
| Mailing Telephone | 6012645756 |
| Mailing Fax Number | 6012645013 |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2008-09-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
1771-77 | MS | Dental Providers |
| Street Address |
6194 HWY 98 WEST |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572965 | Resilient Therapy and Solutions, Pllc | Clinic/Center | 5266 Old Hwy 11 Ste 50, #308, Hattiesburg, MS 39402 | 2020-09-12 |
| 1932710225 | Jones County Medical Supplies, Inc | Durable Medical Equipment & Medical Supplies | 6424 Hwy 98 West, Suite 20, Hattiesburg, MS 39402 | 2020-08-11 |
| 1467086736 | Elizabeth A. Perry | Technician | 1220 Marrie St, Hattiesburg, MS 39402 | 2020-02-26 |
| 1225678063 | Connor Gregory Galloway | Physical Therapist | 3688 Veteran Memorial Drive, Hattiesburg, MS 39402 | 2020-01-09 |
| 1487291456 | Megan Marie Smith | Social Worker | 11 Woodstone Plaza, Hattiesburg, MS 39402 | 2019-12-09 |
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1295392074 | Hattiesburg Clinic, Pa | Preventive Medicine | 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 | 2019-05-28 |
| 1760945356 | Rachandeep Chahal | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street Merit Health Wesley, Hattiesburg, MS 39402 | 2019-04-10 |
| 1386101137 | Courtney L Smith | Behavior Technician | 32 Millbanch Road, Suite 40, Hattiesburg, MS 39402 | 2019-02-28 |
| 1891269940 | Amanda Laine Mcarthur-macisaac | Registered Nurse | 5909 Highway 49 South, Suite 30, Hattiesburg, MS 39402 | 2019-01-11 |
| Find all providers in zip 39402 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1588140610 | Amadia J Giles | Dentist | 6668 U S Highway 98 Ste G, Hattiesburg, MS 39402-7982 | 2018-07-11 |
| 1780176677 | Samuel Eric Johnson | Dentist | 5128 Old Highway 11 Ste 7, Hattiesburg, MS 39402-6234 | 2018-06-05 |
| 1093234684 | John Davis | Dentist | 7100 Highway 98, Suite 210, Hattiesburg, MS 39402-8601 | 2017-09-14 |
| 1194166017 | Zachariah Lea Crawford | Dentist | 47 E Lake Rd, Hattiesburg, MS 39402-7706 | 2013-07-08 |
| 1154760510 | Bluebonnet Dental Care Hattiesburg LLC | Dentist | 6668 Hwy 98 West Ste G, Hattiesburg, MS 39402 | 2013-06-19 |
| 1285999367 | Elise Burton Graham | Dentist | 4301 Lincoln Rd, Suite 10, Hattiesburg, MS 39402-3036 | 2012-07-05 |
| 1215251673 | Barnes Family Dentistry | Dentist | 5910 Highway 49, Ste 15, Hattiesburg, MS 39401-7585 | 2010-03-15 |
| 1154561728 | Lake Serene Family Dental Clinic | Dentist | 6668 U S Highway 98, Ste. G, Hattiesburg, MS 39402-7981 | 2009-02-23 |
| 1952572034 | Michael Trent Webb | Dentist | 69 Grand Jct, Suite G, Hattiesburg, MS 39402-7974 | 2008-03-18 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
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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.