Wallace, Catherine

Wallace, Catherine is an individual health care provider with primary practice located at 243 Merchants Dr , Dallas GA 30132-4700. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Wallace, Catherine can be contacted via phone (770) 230-9967.

Contact Information

Primary practice address
243 Merchants Dr Dallas GA 30132-4700
Phone: (770) 230-9967
Fax: (770) 445-5860
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 94669 Georgia

Profile Details

NPI number 1154946606
LBN Legal business name Wallace, Catherine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2020
Last updated May 2nd, 2023 - about 3 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 1154946606 NPPES
Georgia Other 8101560001 DME MAC JURISDICTION C

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