DR. HAROLD JAMES WALLACE III (NPI# 1770504888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770504888 |
Entity Type | Individual |
Full Name | DR. HAROLD JAMES WALLACE III |
Credential | M.D. |
Practice Address |
111 Colchester Ave Fletcher Allen Health Care Dept. of Radiation Oncology Burlington VT 05401-1473 |
Mailing Address |
291 Moody St Per Se Technologies Ludlow MA 01056-1246 |
Practice Telephone | 8028473506 |
Practice Fax Number | 8028472386 |
Mailing Telephone | 8008666663 |
Mailing Fax Number | 8884131065 |
Enumeration Date | 2006-07-22 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
042-0009975 | VT | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
VT | OVN2161 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699045302 | Harold Wayne Wallace | Counselor | 21 Wallbrook Trl, Odessa, TX 79762-5213 | 2012-01-11 |
Street Address |
111 COLCHESTER AVE FLETCHER ALLEN HEALTH CARE DEPT. OF RADIATION ONCOLOGY |
City | BURLINGTON |
State | VT |
Zip Code | 05401-1473 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376548354 | Richard A. Boothby | Obstetrics & Gynecology | 111 Colchester Ave, Burlington, VT 05401-1473 | 2005-06-16 |
1992304513 | Jennifer Smith Henry | Registered Nurse | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-10-23 |
1922606581 | Jessica Fischer | Dietitian, Registered | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-10-15 |
1922615855 | Emily R Pichler | Psychologist | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-09-24 |
1285257618 | Nadia Stefania Fletcher | Registered Nurse | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-05-20 |
1538781380 | Jeffrey Raymond Gonzalez | Pharmacist | 111 Colchester Ave, Mailstop 272ba1, Burlington, VT 05401 | 2020-05-15 |
1588292874 | Breshawn Best | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-31 |
1528696853 | Nektarios Konstantinopoulos | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-31 |
1457989071 | Siddique Tanzeem Akram | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-30 |
1184252124 | Steven Direda II | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-27 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821626748 | John Henry Priester Jr. | Student in an Organized Health Care Education/Training Program | University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT 05401 | 2020-03-27 |
1730649054 | Parisa Heidari | Student in an Organized Health Care Education/Training Program | Uvmmc 111 Colchester Avenue, Burlington, VT 05401 | 2019-03-22 |
1689141988 | No Diet Dietitian, LLC | Dietitian, Registered | 163 Bayberry Circle #204, Burlington, VT 05401 | 2018-10-25 |
1073097267 | Katherine Dwyer | Physical Therapist | 128 Lakeside Ave, Burlington, Vt, 05401, Burlington, VT 05401 | 2018-09-24 |
1710469481 | Nicholas A Fredette | Nurse Practitioner | 28 S. Williams St., Burlington, VT 05401 | 2018-08-30 |
1760987473 | Tyler Fanning | Psychiatry & Neurology | Uvmmv 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-26 |
1356845416 | Rachel Carlson | Student in an Organized Health Care Education/Training Program | Uvmmc, 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-22 |
1487152096 | Garnet Transport Medicine, LLC | Ambulance | 70 S Winooski Ave Ste 255, Burlington, VT 05401 | 2018-01-29 |
1689172660 | Valerie Goldberg | Dietitian, Registered | 163 Bayberry Circle Apt 204, Burlington, VT 05401 | 2018-01-25 |
1548774235 | Emily R Day | Physical Therapist | 160 Flynn Avenue, Burlington, VT 05401 | 2017-11-17 |
Find all providers in zip 05401 |
Taxonomy Code | 2085R0001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Radiation Oncology |
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346498789 | Klaudia Hunter | Radiology | Lahey Clinic Dept of Radiation Oncology, 41 Mall Rd, Burlington, MA 01805-0001 | 2008-08-27 |
1770588923 | Gene Wong | Radiology | 41 Mall Rd, Burlington, MA 01805 | 2005-06-15 |
1598154411 | Glenn Chrystal | Radiology | 1236 Huffman Mill Rd, Burlington, NC 27215-8700 | 2015-01-15 |
1467727685 | Nataniel Hernan Lester-coll | Radiology | 111 Colchester Ave, Burlington, VT 05401-1473 | 2012-03-21 |
1619266624 | Fletcher Allen Health Care Inc | Radiology | 111 Colchester Ave, Burlington, VT 05401-1473 | 2011-03-30 |
1043443518 | Carl Nelson | Radiology | 111 Colchester Ave, Dept of Radiation Oncology, Burlington, VT 05401-1473 | 2009-08-31 |
1407059371 | Havaleh Marie Gagne | Radiology | 111 Colchester Ave, Mc 301sh2, Burlington, VT 05401-1473 | 2007-06-07 |
1952513392 | Howard Chia-hao Hsu | Radiology | 41 Mall Rd, Burlington, MA 01805-0001 | 2007-05-06 |
1780724690 | North Carolina Radiation Oncology Affiliates Pa | Radiology | 1236 Huffman Mill Rd, Suite 120, Burlington, NC 27215-8700 | 2007-02-08 |
1255488102 | Herbert H Leventhal | Radiology | Lahey Clinic, 41 Mall Road, Burlington, MA 01805-0001 | 2007-01-04 |
Find all providers in BURLINGTON |
City | BURLINGTON |
Zip Code | 05401 |
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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.