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SCOTT ANDREW WALLACE M.D. NPI 1275809899


NPI Information

NPI: 1275809899
Provider Name: SCOTT ANDREW WALLACE, M.D.
Classification: Preventive Medicine - 2083P0500X
Entity Type: Individual

Specialization: Preventive Medicine/Occupational Environmental Medicine

PECOS Registration: Yes

Address:
NAVY MEDICINE SUPPORT COMMAND ATTN: MED STAFF SERVICES
BLDG H 2005 KNIGHT LANE
JACKSONVILLE, FL
ZIP 32212
Phone: (619) 532-7935
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Scott Andrew Wallace, M.D. is a preventive medicine/occupational environmental medicine preventive medicine in Jacksonville, FL. The provider is a preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. Scott Andrew Wallace, M.D. NPI is 1275809899. 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:

NAVY MEDICINE SUPPORT COMMAND ATTN: MED STAFF SERVICES
BLDG H 2005 KNIGHT LANE
JACKSONVILLE, FL
ZIP 32212-140
Phone: (619) 532-7935

The NPI 1275809899 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/28/2012 and was last updated on 8/21/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12083P0500XPreventive MedicinePreventive Medicine/Occupational Environmental MedicineD76451MARYLANDYes

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.