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
Phone: (256) 546-4611
Fax: (256) 546-2214
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689623142 | NPPES |
| Alabama | MEDICAID | 114331 |
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