Wallace, Carmel

Wallace, Carmel is an individual health care provider with primary practice located at 138 Leader Ave, Office 241 University Of Kentucky, Department Of Pediatrics, Lexington KY 40506-9983. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wallace, Carmel can be contacted via phone (859) 323-1432.

Contact Information

Primary practice address
138 Leader Ave, Office 241 University Of Kentucky, Department Of Pediatrics Lexington KY 40506-9983
Phone: (859) 323-1432
Fax: (859) 323-3499
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 18479 Kentucky

Profile Details

NPI number 1063419000
LBN Legal business name Wallace, Carmel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2005
Last updated Dec 18th, 2015 - about 11 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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Identifiers

StateTypeNumberIssuer
All States NPI 1063419000 NPPES
Kentucky MEDICAID 64184799

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