JACOB WALLACE M.D. NPI 1871974527

NPI Information

Jacob Wallace, M.D. is a diagnostic radiology radiology in Wichita, KS with 9 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Jacob Wallace, M.D. NPI is 1871974527. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduation Year:2015

The provider's business location address is:

1010 N KANSAS ST
WICHITA, KS
ZIP 67214-124
Phone: (316) 293-2665

The NPI 1871974527 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 6/17/2015 and was last updated on 7/5/2016.

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:

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