| Doctor Name: | DR. WALLACE BYRON MCGAHAN |
| NPI Number: | 1801811781 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 9963 |
| Business Practice Address: | 507 Harley St Scottsboro, AL - 357684218 |
| Business Phone Number: | 2562591314 |
| Business Fax Number: | |
| Mailing Address: | 2912 S Broad St, Apartment G-1 SCOTTSBORO |
| State: | AL |
| Postal Code: | 357697527 |
| Phone Number: | 2562590089 |
| Fax Number: | |
| NPI Enumeration Date: | 07/13/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 9963 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |