Wallace, Amy Jo

Wallace, Amy Jo is an individual health care provider with primary practice located at 861 Old Winston Rd Ste 101 , Kernersville NC 27284-7141. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wallace, Amy Jo can be contacted via phone (336) 904-0143.

Contact Information

Primary practice address
861 Old Winston Rd Ste 101 Kernersville NC 27284-7141
Phone: (336) 904-0143
Fax: (336) 904-0046
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 26169 South Carolina
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 200600865 North Carolina

Profile Details

NPI number 1467487322
LBN Legal business name Wallace, Amy Jo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Nov 4th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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