Wallace Lock M.D.

NPI 1437545761 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1437545761
Gender Male
Enumeration Date 04/14/2015
Last Updated 04/14/2015
Entity Type Individual
Active Over 1 year ago
Practice Location
612 S 12TH ST
FORT SMITH AR, 72901-4702, US
Phone (479) 424-3193
Business Location
111 N 1ST ST
HUGHES AR, 72348-9100, US
Phone (901) 481-0927
Taxonomy Code 390200000X
License State
License Number
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According to our database, Wallace Lock M.D. NPI is 1437545761, taxonomy code is 390200000X Wallace Lock M.D. physically located at 612 S 12th St, Fort Smith AR, 72901-4702. NPI Number Wallace Lock M.D. has the Individual type.

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1437545761 NPI number is provided on an as is basis without warranty of any kind. 1437545761 is maintained by the National Plan & Provider Enumeration System. The contents of Wallace Lock M.D. are for informational purposes only.