Wallace, James Howard

Wallace, James Howard is an individual health care provider with primary practice located at 1600 22Nd Ave Fl 3 , Meridian MS 39301. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Wallace, James Howard can be contacted via phone (601) 693-1055.

Contact Information

Primary practice address
1600 22Nd Ave Fl 3 Meridian MS 39301
Phone: (601) 693-1055
Fax: (601) 482-5312
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X T-2618 Mississippi
Allopathic & Osteopathic Physicians / Urology 208800000X 25034 Mississippi

Profile Details

NPI number 1881794162
LBN Legal business name Wallace, James Howard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Mar 7th, 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 1881794162 NPPES
Mississippi Other T-2618 STATE MEDICAL BOARD
Mississippi MEDICAID 487562499A STATE MEDICAL BOARD
Mississippi MEDICAID 08128741 STATE MEDICAL BOARD
Mississippi MEDICAID G13318 STATE MEDICAL BOARD

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