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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2083T0002X |
Preventive Medicine Specialization: Medical Toxicology |
23348 | AZ | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 323923 | 05 |
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 |
Street Address |
925 E MCDOWELL RD |
City | PHOENIX |
State | AZ |
Zip Code | 85006-2502 |
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 |
Find all providers in the same location |
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 Code | 2083T0002X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Preventive Medicine |
Specialization | Medical Toxicology |
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. |
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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.