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MR. HEATH WADE WALLACE IDC
NPI 1558323725
Military Health Care Provider - Independent Duty Corpsman in Fpo, AE

Active since April 04, 2006
USS THEODORE ROOSEVELT CVN 71, MEDICAL DEPARTMENT, FPO, AE 09599(757) 445-6230 Get Directions Write a Review

NPPES record last updated: April 20, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Heath Wade Wallace Idc NPPES

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

MR. HEATH WADE WALLACE IDC (NPI 1558323725) is an individual independent duty corpsman provider in Fpo, AE and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1558323725
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameMR. HEATH WADE WALLACECredential: IDC
Location AddressUSS THEODORE ROOSEVELT CVN 71, MEDICAL DEPARTMENTFpo, AE 09599-2871
Mailing Address1973 Big Boulder DrVirginia Beach, VA 23456-6126 · (757) 471-1746
Phone(757) 445-6230
Sole ProprietorNo
Enumeration DateApril 4, 2006
Last NPPES UpdateApril 20, 2008
✔ NPI 1558323725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
USS THEODORE ROOSEVELT CVN 71, Fpo, AE 09599
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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 Heath Wallace's NPI number?

The NPI number for Heath Wallace is 1558323725. It was assigned to this individual provider in the NPPES registry on April 4, 2006.

Where is Heath Wallace located?

Heath Wallace practices at Uss Theodore Roosevelt Cvn 71 Medical Department, Fpo, AE 09599. The listed phone number is (757) 445-6230.

What is Heath Wallace's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Heath Wallace was last updated on April 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.