DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JACOB HENRY WALLACE, MD

Active

DR. JACOB HENRY WALLACE, MD is a Obstetrics & Gynecology healthcare provider located in SAINT LOUIS, Missouri. NPI 1124604061 is currently active in the NPPES registry. Verify at CMS.

Obstetrics & Gynecology · SAINT LOUIS, MO

Registration Details

NPI Number
1124604061
Provider Type
Individual
Gender
Male
NPI Issued
Mar 22, 2021 (5.3543342906224 yrs)
Last Updated
Jul 8, 2025
License
2025027770 (MO)

Practice Information

Address
401 HOLLY HILLS AVE
SAINT LOUIS, MO, 631112410
Browse MO providers · Browse ZIP 63111
Phone
3143535190
Fax
3143537631
Primary Specialty
Obstetrics & Gynecology
207V00000X
Additional Specialty
Obstetrics & Gynecology

Other Obstetrics & Gynecology Providers in SAINT LOUIS, MO

Name Credential NPI
DR. LAURA RUTH HULBERT M.D. 1366447336
CATHLEEN FARIS-GUYOL M.D. 1699770297
MICHELLE R DE VERA M.D. 1952306557
KATHLEEN HOGAN M.D. 1750386355
HEATHER WUEBKER M.D. 1477558070
DR. AMY JO RAVIN M.D. 1518963859
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.