KEVIN L WALLACE


Address: 925 E Mcdowell Rd, Phoenix, AZ 85006-2502
Phone: 6022392371

KEVIN L WALLACE (NPI# 1730128372) 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) 1730128372
Entity Type Individual
Full Name KEVIN L WALLACE
Credential MD
Practice Address 925 E Mcdowell Rd
Phoenix
AZ 85006-2502
Mailing Address 72 Brentwood Rd
Cape Elizabeth
ME 04107-2227
Practice Telephone 6022392371
Practice Fax Number 6022394138
Mailing Telephone 6027691301
Mailing Fax Number 2072211113
Enumeration Date 2006-06-06
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2083T0002X Preventive Medicine
Specialization: Medical Toxicology
23348 AZ Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AZ 323923 05

Other Providers KEVIN WALLACE

NPI Name Taxonomy Address Enumeration
1659760700 Kevin Wallace Naturopath 1700 N Tully Rd Apt G221, Turlock, CA 95380-6879 2015-01-13
1144576919 Kevin Gary Wallace Pharmacist 94 Ladd Ave, Staten Island, NY 10312-1515 2012-07-31
1972750909 Kevin D Wallace Dentist 1200 E Woodhurst Dr Ste A200, Springfield, MO 65804-3745 2008-08-21
1316960131 Kevin Bruce Wallace Dentist 949 N 14th St, Leesburg, FL 34748-3838 2006-07-25
1033619614 Kevin R Wallace Case Manager/Care Coordinator 3620 Stutz Dr, Canfield, OH 44406-9176 2018-02-20
1518391135 Kevin Wallace Massage Therapist 817 Coffee Rd Ste D, Modesto, CA 95355-4241 2013-08-30
1225388457 Kevin Wallace Student in an Organized Health Care Education/Training Program 30 Warren St, Boston, MA 02135-3602 2012-09-14
1053423285 Kevin R Wallace Dentist 150 E Huron St, Ste 1103, Chicago, IL 60611 2006-09-01
1255309258 Kevin Ps Wallace Internal Medicine 1300 Crane St, Menlo Park, CA 94025-4260 2006-03-08
1033195631 Kevin H Wallace Internal Medicine 1350 Hickory St, Melbourne, FL 32901-3224 2005-12-16

Office Location

Street Address 925 E MCDOWELL RD
City PHOENIX
State AZ
Zip Code 85006-2502

Providers in the same location

NPI Name Taxonomy Address Enumeration
1386649564 Michael John Conway Surgery 925 E Mcdowell Rd, Phoenix, AZ 85006 2005-06-15
1992220719 Samantha Kathryn Sorg Physician Assistant 925 E Mcdowell Rd, Phoenix, AZ 85006 2017-08-14
1114378841 Phillip Standen Surgery 925 E Mcdowell Rd, Phoenix, AZ 85006-2502 2016-06-23
1003266677 Lacey Wood Surgery 925 E Mcdowell Rd, Department of Surgery, Phoenix, AZ 85006-2502 2016-06-15
1821448499 Kelsey Hoidal Surgery 925 E Mcdowell Rd, Department of Surgery, Phoenix, AZ 85006-2502 2016-06-15
1003266701 Angela Arreola Surgery 925 E Mcdowell Rd, Phoenix, AZ 85006-2502 2016-06-14
1326498965 Robert Maher Surgery 925 E Mcdowell Rd, Department of Surgery, Phoenix, AZ 85006-2502 2016-06-14
1518317213 Jena Bunda Surgery 925 E Mcdowell Rd, Phoenix, AZ 85006-2502 2016-06-14
1932559572 Morgan Crigger Surgery 925 E Mcdowell Rd, Department of Surgery, Phoenix, AZ 85006-2502 2016-06-14
1316397003 Caitlin Thornley Surgery 925 E Mcdowell Rd, Phoenix, AZ 85006-2502 2016-06-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1356949929 Teresa Louise Cox Pharmacist 1800 E Van Buren St., St. Luke's Behavioral Health, Phoenix, AZ 85006 2020-10-15
1558985036 Amanda Stanford Nurse Practitioner 925 E Mc Dowell Rd, Phoenix, AZ 85006 2020-06-01
1023638582 Supraja Prakash Genetic Counselor, MS 1920 E Cambridge Ave., Rosenberg Bldg., Suite 304, Phoenix, AZ 85006 2020-04-24
1760017099 Phoenix Medical Psychiatric Hospital, LLC Psychiatric Hospital 1346 Mcdowell Road, Phoenix, AZ 85006 2020-03-06
1265093108 Zulianna Ibrahim Student in an Organized Health Care Education/Training Program Banner University Medical Center Phoenix Family Medicin, 1300 N. 12th Street Suite 605, Phoenix, AZ 85006 2019-06-21
1306318340 Leah Margaret Hillier Family Medicine 1300 N 12th St - Suite 500, Phoenix, AZ 85006 2018-12-31
1477032357 Joann Moskop Chiropractor 2719 N Greenfield Rd., Phoenix, AZ 85006 2018-08-10
1619464468 Ana Maria Lara Naturopath 926 E Mcdowell Rd Ste 204, Phoenix, AZ 85006 2018-04-17
1194221770 Nisha Bharat Patel Student in an Organized Health Care Education/Training Program Edwards Medical Plaza Suite 320, 1300 North 12th Street, Phoenix, AZ 85006 2018-04-03
1710486352 Julia Cyr Registered Nurse 1008 E Mcdowell Rd Unit A, Phoenix, AZ 85006 2018-02-09
Find all providers in zip 85006

Taxonomy Information

Taxonomy Code 2083T0002X
Grouping Allopathic & Osteopathic Physicians
Classification Preventive Medicine
Specialization Medical Toxicology

Taxonomy Definition

Medical toxicologists are physicians who specialize in the prevention, evaluation, treatment and monitoring of injury and illness from exposures to drugs and chemicals, as well as biological and radiological agents. Medical toxicologists care for people in clinical, academic, governmental and public health settings, and provide poison control center leadership. Important areas of medical toxicology include acute drug poisoning, adverse drug events, drug abuse, addiction and withdrawal, chemicals and hazardous materials, terrorism preparedness, venomous bites and stings, and environmental and workplace exposures.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine.

Competitor

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City PHOENIX
Zip Code 85006

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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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