NPI 1124136221 DR. BRENT E WALLACE MD SALT LAKE CITY UT. Find Phone Number, Address, Contact details of medical healthcare providers | NPI Number Lookup

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Dr. Brent E Wallace - NPI: 1124136221

National Provider Identifier (NPI) is a 10-digit identification number which is issued to health care providers by the Centers for Medicare and Medicaid Services (CMS) in the United States(US). The NPI is introduced to replace of UPIN (unique provider identification number) and now NPI is the only required identifier for Medicare services, and NPI is also used by commercial healthcare insurers and by other payers.

Doctor Name: DR. BRENT E WALLACE
NPI Number: 1124136221
Entity Type Code: Individual (1)
Gender: M
Credentials: MD
License Number: 771610101205
Business Practice Address: 1915 W 5950 S
Roy, UT - 840671454
Business Phone Number: 8013878100
Business Fax Number:
Mailing Address: Po Box 27128,
SALT LAKE CITY
State: UT
Postal Code: 841270128
Phone Number: 8013878100
Fax Number:
NPI Enumeration Date: 08/28/2006
NPI Last Update Date: 07/10/2008
Replacement NPI: 0
NPI Deactivation Date:
NPI Reactivation Date:

Taxonomy Information:

Healthcare Provider Taxonomy: 207Q00000X
License Number: 771610101205
Healthcare Provider Taxonomy:
(Secondary)
Y
State: UT
Taxonomy Type: Allopathic & Osteopathic Physicians
Taxonomy Classification: Family Medicine
Taxonomy Specialization:
Taxonomy Definition:
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.


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