John Wall MD

NPI 1003899071 - Family Medicine - 207Q00000X

NPI Details
NPI 1003899071
Gender Male
Enumeration Date 11/23/2005
Last Updated 07/09/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
1200 W STATE ST
ROCKFORD IL, 61102-2112, US
Phone (815) 490-1600
Fax
Business Location
480 MERIDIAN ST
VILLAGE OF LAKEWOOD IL, 60014-5416, US
Phone (815) 459-2658
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State
License Number
Remove 1003899071 NPI Number
 

According to our database, Dr. John Wall MD NPI is 1003899071, taxonomy code is 207Q00000X John Wall MD physically located at 1200 W State St, Rockford IL, 61102-2112. NPI Number John Wall MD has the Individual type.

Sponsored links

1003899071 NPI number is provided on an as is basis without warranty of any kind. 1003899071 is maintained by the National Plan & Provider Enumeration System. The contents of John Wall MD are for informational purposes only.