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MARK E WALLACE MD
NPI 1083603088
Family Medicine in Greeley, CO

Active since October 21, 2005
1600 23RD AVE, GREELEY, CO 80634(970) 356-2424(970) 346-2774 Get Directions Write a Review

NPPES record last updated: December 20, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mark E Wallace Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK E WALLACE MD (NPI 1083603088) is an individual family medicine provider in Greeley, Colorado, licensed in Colorado (DR32010) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1083603088
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMARK E WALLACECredential: MD
Location Address1600 23RD AVEGreeley, CO 80634-6070
Mailing Address1600 23rd AveGreeley, CO 80634-6070 · (970) 356-2424 · Fax (970) 346-2774
Phone(970) 356-2424
Fax(970) 346-2774
Sole ProprietorNo
Enumeration DateOctober 21, 2005
Last NPPES UpdateDecember 20, 2010
✔ NPI 1083603088 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in CO · DR32010✔ Licensed in CA · G056273
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1600 23RD AVE, Greeley, CO 80634
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Other Identifiers 4

Medicaid01320100CO
Medicare PINC173548CO
Medicare UPINA53109
Medicare PINCOA102818CO

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DOROTHY MARIE SCHULTE FNP
Nurse Practitioner
1600 23RD AVE
GREELEY, CO 80634
Weld County (970) 356-2424
ELIZABETH ANNE MARIE POSKIE MD
Student in an Organized Health Care Education/Training Program
1600 23RD AVE
GREELEY, CO 80634
Weld County (970) 810-2424
JENNA MARIE HESSLER MD
Family Medicine
1600 23RD AVE
GREELEY, CO 80634
Weld County (406) 437-3002
DR. AYNSLEY QI-WEN HARTNEY MD
Student in an Organized Health Care Education/Training Program
1600 23RD AVE
GREELEY, CO 80634
Weld County (970) 810-2424
BETHANY PAJ TSIS THAWJ XIONG-KOON
Student in an Organized Health Care Education/Training Program
1600 23RD AVE
GREELEY, CO 80634
Weld County (303) 929-3768
STEPHEN ZERLANG
Family Medicine
1600 23RD AVE
GREELEY, CO 80634
Weld County (970) 346-2800
HEALTHONE CLINIC SERVICES - PEDIATRIC SPECIALTIES LLC
Pediatrics (Pediatric Cardiology)
1600 23RD AVE
GREELEY, CO 80634
Weld County (303) 860-9933
KACEY JANE KEMPER
Student in an Organized Health Care Education/Training Program
1600 23RD AVE
GREELEY, CO 80634
Weld County (970) 810-2424

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Wallace's NPI number?

The NPI number for Mark Wallace is 1083603088. It was assigned to this individual provider in the NPPES registry on October 21, 2005.

Where is Mark Wallace located?

Mark Wallace practices at 1600 23rd Ave, Greeley, CO 80634. The listed phone number is (970) 356-2424.

What is Mark Wallace's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Mark Wallace was last updated on December 20, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.