Ty Lamar Wallace MSW

  • NPI 1295257624
According to our database, the NPI number for Ty Lamar Wallace MSW is 1295257624 and activated since 6 years ago. Ty Lamar Wallace MSW is an individual provider who specializes in Clinical, and the primary practice location is 4904 Bowls Bottom Rd, Pinckneyville, IL 62274. You can also contact Ty Lamar Wallace MSW via telephone number is (618) 926-6050. Provider NPI information was last updated on 07/07/2017.

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Overview of Ty Lamar Wallace MSW

  • NPI number: 1598434045
  • Provider type: Individual
  • Gender: Male
  • Active since: 07/07/2017
  • Last updated: 07/07/2017

Primary Scrop of Practice

  • Taxonomy Code: 1041C0700X
  • Specialty: Clinical
  • License Number: 149-010121
  • License State: IL

Provider Mailing Address

  • Address: 4904 Bowls Bottom Rd
    Pinckneyville, IL 62274
  • Phone: 618-926-6050
  • Fax:

Provider Practice Location

  • Address: 4904 Bowls Bottom Rd
    Pinckneyville, IL 62274
  • Phone: (618) 926-6050
  • Fax:

Scope of Practice

  • Taxonomy Code: 1041C0700X
  • Specialty: Clinical
  • License Number: 149-010121
  • License State: IL
  • Switch: Yes

Question & Answers

  • Q: What is the npi number?
  • A: An NPI is a 10-digit numeric identifier. It does not carry information about you, such as the State where you practice, your provider type, or your specialization. Your NPI will not change, even if your name, address, taxonomy, or other information changes.
  • Q: What are health care provider taxonomy codes?
  • A: The Health Care Provider (HCP) Taxonomy Codes Codes define a health care service provider type, classification, and area of specialization.
  • Q: What is the npi number for Ty Lamar Wallace MSW?
  • A: The npi number for Ty Lamar Wallace MSW is 1295257624.
  • Q: What are Ty Lamar Wallace MSW's specialties?
  • A: Ty Lamar Wallace MSW's specialties are Clinical and different specialities.
  • Q: What is the medical license for Ty Lamar Wallace MSW?
  • A: The medical license number for Ty Lamar Wallace MSW is 149-010121 and issued in IL in USA.
  • Q: Where is Ty Lamar Wallace MSW practice location?
  • A: Ty Lamar Wallace MSW is practicing at 4904 Bowls Bottom Rd, Pinckneyville, IL 62274.
  • Q: How to contact Ty Lamar Wallace MSW?
  • A: You can contact Ty Lamar Wallace MSW via (618) 926-6050.
Medicare Specialty
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Family Health
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Sports Medicine
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