DR. JUSTIN K WALLACE (NPI# 1649609728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649609728 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN K WALLACE |
| Credential | D.V.M. |
| Practice Address |
120 S 6th St Chickasha OK 73018-3420 |
| Practice Telephone | 4052248023 |
| Practice Fax Number | 4052248024 |
| Mailing Telephone | 4052248023 |
| Mailing Fax Number | 4052248024 |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2013-11-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174M00000X | Veterinarian | 5380 | OK | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417331679 | Justin Matthew Wallace | Marriage & Family Therapist | 1322 E Shaw Ave Ste 410, Fresno, CA 93710-7904 | 2015-07-16 |
| 1114354156 | Justin Cory Wallace | Military Health Care Provider | 699 14th St, San Diego, CA 92101-7586 | 2013-10-06 |
| 1578807103 | Justin Covey Wallace | Registered Nurse | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2012-11-20 |
| 1033372594 | Justin Robert Wallace | Surgery | 530 South St, Suite 380, Greensburg, PA 15601-2775 | 2008-07-05 |
| Street Address |
120 S 6TH ST |
| City | CHICKASHA |
| State | OK |
| Zip Code | 73018-3420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821528662 | Cancer Centers of Southwest Oklahoma, LLC | Internal Medicine | 210 South Mary Bailey Drive, Chickasha, OK 73018 | 2017-06-14 |
| 1821535915 | Around The Clock Home Care | In Home Supportive Care | 313 W Chickasha Ave, Chickasha, OK 73018 | 2017-01-26 |
| 1639535537 | Teagan Rae Dorsey | Registered Nurse | 304 S 29th Street, Chickasha, OK 73018 | 2016-01-07 |
| 1578949327 | Megan Griffin | Dentist | 720 West Grand Ave, Chickasha, OK 73018 | 2015-08-04 |
| 1174933709 | Mendy Stone | Case Manager/Care Coordinator | 1820 Wets Idaho Ave, Chickasha, OK 73018 | 2014-05-05 |
| 1407286735 | Martha Allison Shadoan | Social Worker | 804 W. Choctaw, Chickasha, OK 73018 | 2013-11-22 |
| 1225313521 | Shanna Michelle Rice | Counselor | 198 East Almar Drive, Chickasha, OK 73018 | 2011-10-18 |
| 1306016175 | Logsdon Chiropractic, Pllc | Clinic/Center | 1807 S. 9th, Chickasha, OK 73018 | 2008-03-07 |
| 1518148337 | Christopher Lee Ludwell | Chiropractor | 419 Fieldcrest, Chickasha, OK 73018 | 2007-11-20 |
| 1902098270 | Barbara Ann Reilley Schmidt | Pediatrics | 2222 West Iowa, Chickasha, OK 73018 | 2007-08-10 |
| Find all providers in zip 73018 | ||||
| Taxonomy Code | 174M00000X |
| Grouping | Other Service Providers |
| Classification | Veterinarian |
| A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |
| Notes: Source: Dorland’s Illustrated Medical Dictionary. 28th edition. Philadelphia: W.B. Saunders Company, 1994, p. 1823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235509340 | Jon Tevebaugh | Veterinarian | 61950 Grant Rd, Cherokee, OK 73728-5503 | 2015-10-01 |
| 1376926204 | Ginger Lanye | Veterinarian | 6319 S Elm Pl, Broken Arrow, OK 74011-4101 | 2015-07-09 |
| 1871974477 | Brooks Terrel | Veterinarian | 8701 Se 29th St, Midwest City, OK 73110-8204 | 2015-06-09 |
| 1265811236 | Paige Mackey | Veterinarian | 2113 W Farm Rd, Stillwater, OK 74078-0001 | 2015-05-23 |
| 1548693567 | Jordan Cassidy | Veterinarian | 1 Bvmth, Oklahoma State University, Stillwater, OK 74078-0001 | 2013-08-13 |
| 1699114165 | Jennifer Thomas | Veterinarian | 2021 Cedar Ct, Stillwater, OK 74075-8256 | 2013-06-18 |
| 1275970642 | Staci Leigh Robertson | Veterinarian | 1121 N Mockingbird Ln, Stillwater, OK 74075-8678 | 2013-05-26 |
| 1497092183 | Paul Willam Dean | Veterinarian | 7222 E 41st St, Tulsa, OK 74145-4504 | 2013-01-15 |
| 1417201179 | Kimberly Dawn Ferguson | Veterinarian | 2183 County Street 2760, Verden, OK 73092 | 2012-11-02 |
| 1417229485 | Vernon Lee Newby | Veterinarian | 817 Madison Blvd., Bartlesville, OK 74006 | 2012-02-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.