Dr Robert G Wallace, MD is a
Radiology - Diagnostic Radiology physician based in Fortson, Georgia. Dr Robert G Wallace is licensed to practice in Georgia (license number 13317) and his current practice location is 1130 Goat Rock Road, Fortson, Georgia. He can be reached at his office (for appointments etc.) via phone at
(706) 323-6485.
NPI number for Dr Robert G Wallace is 1780015610 and his current mailing address is P.o. Box 2787, Columbus, Georgia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1780015610.
Physician's Profile
| Full Name | Dr Robert G Wallace |
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| Gender | Male |
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| Speciality | Radiology - Diagnostic Radiology |
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| Location | 1130 Goat Rock Road, Fortson, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1780015610
- Provider Enumeration Date: 12/03/2013
- Last Update Date: 12/03/2013
Medical Identifiers
Medical identifiers for Dr Robert G Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780015610 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2085N0904X | Radiology - Nuclear Radiology | 13317 (Georgia) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 13317 (Georgia) | Primary |
| 2085U0001X | Radiology - Diagnostic Ultrasound | 13317 (Georgia) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Robert G Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Robert G Wallace, MD
P.o. Box 2787,
Columbus, GA 31902
Ph: (706) 323-6485 | Dr Robert G Wallace, MD
1130 Goat Rock Road,
Fortson, GA 31808
Ph: (706) 323-6485 |
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