Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
EMMETT LEE WALLACE, DO
Active Sole ProprietorEMMETT LEE WALLACE, DO is a Family Medicine healthcare provider located in BETTENDORF, Iowa. NPI 1215992334 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · BETTENDORF, IA
Registration Details
- NPI Number
- 1215992334
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 20, 2006 (20.342994832849 yrs)
- Last Updated
- Jul 22, 2011
- Licenses
-
01133 (IA)27754 (MO)03652892 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1019 BROADLAWN AVENUEBETTENDORF, IA, 52722Browse IA providers · Browse ZIP 52722
- Phone
- 5633591181
- Fax
- 5633863177
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
- Additional Specialty
- Family Medicine
Other Family Medicine Providers in BETTENDORF, IA
| Name | Credential | NPI |
|---|---|---|
| DR. STEVEN J AGUILAR | MD | 1427053842 |
| CHRISTOPHER M CROME | MD | 1205831211 |
| MARK E HERMANSON | MD | 1639174196 |
| JAMES A LINDLEY | MD | 1528064052 |
| BRUCE A MCELHINNEY | DO | 1811993371 |
| ANJI A NEIL | MD | 1801892328 |
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.