Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. GARY WAYNE WALLACE, M.D.
ActiveOphthalmology · IDAHO FALLS, ID
Registration Details
- NPI Number
- 1144335290
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 20, 2006 (19.688036159353 yrs)
- Last Updated
- May 26, 2011
- License
-
M-6226 (ID)
Practice Information
- Address
-
2295 CORONADO STREETIDAHO FALLS, ID, 83404Browse ID providers · Browse ZIP 83404
- Phone
- 2085248600
- Fax
- 2085248394
- Primary Specialty
-
Ophthalmology
207W00000X
Other Ophthalmology Providers in IDAHO FALLS, ID
| Name | Credential | NPI |
|---|---|---|
| DR. ERIC K ROMRIELL | DO | 1922072586 |
| DR. AARON JON AFFLECK | MD | 1861507857 |
| DR. BRADLEY P GARDNER | MD | 1255408217 |
| DR. KENNETH W TURLEY | MD | 1063589034 |
| MR. PETER CARL ZIMMERMAN | MD | 1275685513 |
| RICHARD CANNON | MD | 1992842264 |
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.