John Wallace (NPI# 1992735302, PAC ID# 3870581945) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPHTHALMOLOGY.
| Nation Provider ID (NPI) | 1992735302 |
| PAC ID by PECOS | 3870581945 |
| Professional Enrollment ID | I20090507000063 |
| Full Name | John Wallace |
| Organization Legal Name | EYE SURGICAL ASSOCIATES P C |
| Address |
2664 Hartford Hwy Dothan AL 36305-4904 |
| Phone Number | 3346992245 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 1979 |
| Primary Specialty | OPHTHALMOLOGY |
| Group Practice PAC ID | 5597814525 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 010055 | FLOWERS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2664 Hartford Hwy, Dothan, AL 36305-4904 | 3346992245 | EYE SURGICAL ASSOCIATES P C |
| Organization Legal Name | EYE SURGICAL ASSOCIATES P C |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Allan J Kelley | Ophthalmology | Eye Surgical Associates P C | 2664 Hartford Hwy, Dothan, AL 36305-4904 |
| Street Address |
2664 HARTFORD HWY |
| City | DOTHAN |
| State | AL |
| Zip | 36305-4904 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Allan J Kelley | Ophthalmology | Eye Surgical Associates P C | 2664 Hartford Hwy, Dothan, AL 36305-4904 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Norma Faye Mcknight | Nurse Practitioner | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Kelli N Heer | Physician Assistant | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Robert M Hagler | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Tonia L Ruddock | Dermatology | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Laura M Tamburin | Dermatology | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Candace N Short | Nurse Practitioner | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| James Butler | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Craig D Omohundro | Dermatology | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Philip Mathew Dozier | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Christopher E Nicholls | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Find all physicians in zip 36305 | |||
| City | DOTHAN |
| Zip Code | 36305 |
| Specialty | OPHTHALMOLOGY |
| City + Specialty | DOTHAN + OPHTHALMOLOGY |
Please comment or provide details below to improve the information on John Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.