Wallis, Vicki Jo

Wallis, Vicki Jo is an individual health care provider with primary practice located at 829 Riverbend Dr , Gadsden AL 35901-2556. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wallis, Vicki Jo can be contacted via phone (256) 546-4611.

Contact Information

Primary practice address
829 Riverbend Dr Gadsden AL 35901-2556
Fax: (256) 546-2214
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 22626 Alabama

Profile Details

NPI number 1689623142
LBN Legal business name Wallis, Vicki Jo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Jun 5th, 2013 - about 13 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 1689623142 NPPES
Alabama MEDICAID 114331

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