AUDREY WALLACE MD NPI 1396185666

NPI Information

  • NPI: 1396185666
  • Provider Name: AUDREY WALLACE, MD
  • Classification: Radiology - 2085R0001X
  • Specialization: Radiation Oncology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2020 SE 17TH ST
    OCALA, FL
    ZIP 34471
  • Phone: (352) 732-0277

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NPI Details

Audrey Wallace, MD is a radiation oncology radiology in Ocala, FL with 13 years of experience. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. Audrey Wallace, MD NPI is 1396185666. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduation Year:2013

The provider's business location address is:

2020 SE 17TH ST
OCALA, FL
ZIP 34471-118
Phone: (352) 732-0277

The NPI 1396185666 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 7/1/2013 and was last updated on 5/16/2025.

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
12085R0001XRadiologyRadiation Oncology33689ALABAMANo
2390200000XStudent in an Organized Health Care Education/Training ProgramNo
32085R0001XRadiologyRadiation OncologyME136800FLORIDAYes

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: 11/21/2025

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