DR. ERIC L WALLACE


Address: 700 W Ironwood Dr, 320, Coeur D Alene, ID 83814-2656
Phone: 2086255250

DR. ERIC L WALLACE (NPI# 1568658243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1568658243
Entity Type Individual
Full Name DR. ERIC L WALLACE
Credential D.O.
Practice Address 700 W Ironwood Dr
320
Coeur D Alene
ID 83814-2656
Practice Telephone 2086255250
Mailing Telephone 2086255250
Enumeration Date 2007-09-17
Last Update Date 2015-12-31
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine 03263 KY Allopathic & Osteopathic Physicians
N 207R00000X Internal Medicine 2007-014326 NC Allopathic & Osteopathic Physicians
N 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
O0839 ID Allopathic & Osteopathic Physicians
Y 207RI0011X Internal Medicine
Specialization: Interventional Cardiology
OP60505950 WA Allopathic & Osteopathic Physicians

Other Providers ERIC WALLACE

NPI Name Taxonomy Address Enumeration
1417183476 Eric T Wallace Physical Therapist W5361 County Road Kk Ste E, Appleton, WI 54915-7271 2009-06-04
1922218809 Eric Wallace Radiologic Technologist 4004 Landside Dr, Louisville, KY 40220-3020 2007-05-22
1871706960 Eric Wallace Emergency Medicine Paula Bldg 230, 728 Richard Arrington Blvd, Birmingham, AL 35294-0001 2007-05-07
1174665277 Eric H Wallace Dentist 28 Se 6th St, Boca Raton, FL 33432-6016 2007-02-13
1780614529 Eric L. Wallace Surgery 1450 Matthews Township Parkway, Suite 300, Matthews, NC 28105 2006-07-04
1912409160 Eric Wallace Psychologist 22001 Fairmount Blvd, Shaker Heights, OH 44118-4819 2018-03-05
1528333838 Eric Joseph Wallace Jr. Radiology 1542 Tulane Ave, Room 353, New Orleans, LA 70112-2865 2012-03-20
1891838991 Eric Michael Wallace Dentist 1515 State St, Suite 9, Santa Barbara, CA 93101-2536 2007-02-15
1154434488 Eric Wallace Family Medicine 143 Longwater Dr, Norwell, MA 02061-1683 2006-08-17
1578502191 Eric Wallace Radiology 168 N Brent St, Suite 402, Ventura, CA 93003-2817 2006-06-06

Office Location

Street Address 700 W IRONWOOD DR
320
City COEUR D ALENE
State ID
Zip Code 83814-2656

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699771451 Ronald J Stout Otolaryngology 700 W Ironwood Dr, Ste 236, Coeur D Alene, ID 83814-4484 2005-06-24
1033635180 Jamie Lee Park Pharmacist 700 W Ironwood Dr, Coeur D Alene, ID 83814-2656 2017-08-21
1063944726 Mandi Nordhagen Pharmacist 700 W Ironwood Dr, Suite 228, Coeur D Alene, ID 83814-2656 2017-03-31
1679004675 Jamie Cervi-skinner Pharmacist 700 W Ironwood Dr, Suite 246, Coeur D Alene, ID 83814-2656 2017-03-22
1982144424 Carissa Hober Pharmacist 700 W Ironwood Dr, Suite 246, Coeur D Alene, ID 83814-2656 2017-03-02
1861939910 Kellie Kathryn Breaux Nurse Practitioner 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814-2656 2017-01-27
1902348709 Michael Watrobka Physician Assistant 700 W Ironwood Dr, Suite 120e, Coeur D Alene, ID 83814-2656 2016-11-09
1841748530 Elizabeth St John Physician Assistant 700 W Ironwood Dr, Ste 341, Coeur D Alene, ID 83814-2656 2016-09-12
1184076465 Craig Allred Audiologist 700 W Ironwood Dr, Ste 278, Coeur D Alene, ID 83814-2656 2016-07-11
1962869008 Natalie Jeane Bartell Nurse Practitioner 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814-2656 2016-01-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477162675 Dehra Mcfaddan Social Worker 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 2020-07-24
1043838634 Yendi Labelle Nurse Practitioner 1115 N Ironwood Drive, Coeur D'alene, ID 83814 2020-07-09
1295353217 Cultivation, LLC Counselor 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 2020-07-07
1306487517 Northwest Integrated Health, LLP Clinic/Center 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 2019-09-30
1730740465 Connor Williams Physical Therapist 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 2019-06-24
1912480153 Nadine M Lewis Social Worker 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 2018-09-13
1992208631 Orthopedic Surgery and Sports Orthopaedic Surgery 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 2018-03-08
1346758042 Heather Marie Johnson Counselor 7905 Meadowlark Way, Cda, ID 83814 2018-01-16
1881113413 Brevity Treatment Services Counselor 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 2017-09-14
1366969628 Jennifer La Gina Highfield Massage Therapist 1104 N Ste B, Coeur D Alene, ID 83814 2017-08-28
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Taxonomy Information

Taxonomy Code 207RI0011X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Interventional Cardiology

Taxonomy Definition

An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine)

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1942771043 Physician's Choice Cardiology, Pllc Internal Medicine 3302 Valencia, Suite 201, Idaho Falls, ID 83404 2018-12-16
1730688748 Cardiac Cin of Boise LLC Internal Medicine 800 W Main St Ste 1460-10, Boise, ID 83702-5945 2018-02-05
1144544644 Jeffrey J Heslop Internal Medicine 6140 W Curtsian, Ste 200, Boise, ID 83704 2010-03-26
1063674505 Joseph Aloysius Walsh IIi Internal Medicine 6140 W Curtisian Ave Ste 100, Boise, ID 83704 2008-06-26
1093972564 St Patrick Hosp and Health Sci Ctr Internal Medicine 203 S. Daisy St, Salmon, ID 83467-4343 2008-05-21
1932153137 Charles E Eiriksson Jr. Internal Medicine 300 E Jeffreson, Ste 101, Boise, ID 83712 2006-05-20
1346713302 Radial First Holdings Internal Medicine 2001 S Woodruff Ave Ste 12b, Idaho Falls, ID 83404-6372 2019-01-02
1730563909 Radial First Cardiovascular Associates, LLC Internal Medicine 2001 S Woodruff Ave, Suite 3, Idaho Falls, ID 83404-6371 2015-07-16
1952670523 Teton Cardiology PC Internal Medicine 3200 Channing Way, Ste A201, Idaho Falls, ID 83404-7546 2011-12-27
1902197866 Robert Wynn Tonks Internal Medicine 775 Pole Line Rd W Ste 112, Twin Falls, ID 83301-5819 2011-04-27
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Competitor

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City COEUR D ALENE
Zip Code 83814

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Dataset Information

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.

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