DR. RICHARD AUSTIN WALLACE MD NPI 1013957034

NPI Information

NPI: 1013957034
Provider Name: DR. RICHARD AUSTIN WALLACE, MD
Classification: Otolaryngology - 207YX0901X
Entity Type: Individual

Specialization: Otology & Neurotology

Address:
1306 KANAWHA BLVD E
CHARLESTON, WV
ZIP 25301
Phone: (304) 343-4371
Get Directions

DR. Richard Austin Wallace, MD is an otology and neurotology otolaryngology in Charleston, WV. The provider is an otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone. DR. Richard Austin Wallace, MD NPI is 1013957034. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1306 KANAWHA BLVD E
CHARLESTON, WV
ZIP 25301-001
Phone: (304) 343-4371
Fax: (304) 353-0215

The enumeration date for this NPI number is 6/7/2006 and was last updated on 12/12/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207YX0901X	Otolaryngology	Otology & Neurotology	WV11648	WEST VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0493524	MEDICARE PIN	WEST VIRGINIA
2	1013957034	OTHER	WEST VIRGINIA	NPI
3	010107500	MEDICAID	WEST VIRGINIA
4	B42591	MEDICARE UPIN	WEST VIRGINIA
5	0493522	MEDICARE PIN	WEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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