WAYNE O WALLACE JR. MD
NPI 1639175292
Family Medicine in Atchison, KS

Q: What is Wayne Wallace's NPI number?

The NPI number for Wayne Wallace is 1639175292. It was assigned to this individual provider in the NPPES registry on June 28, 2005.

Q: What is Wayne Wallace's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Wayne Wallace was last updated on January 28, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since June 28, 2005

810 RAVEN HILL DRIVE, ATCHISON, KS 66002(913) 367-6689(913) 360-5837 Get Directions Write a Review

NPPES record last updated: January 28, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Wayne O Wallace Jr. Md NPPES

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

WAYNE O WALLACE JR. MD (NPI 1639175292) is an individual family medicine provider in Atchison, Kansas, licensed in Kansas (0413701) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1639175292

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameWAYNE O WALLACE JR.Credential: MD

Location Address810 RAVEN HILL DRIVEAtchison, KS 66002-1401

Mailing Address810 Raven Hill DriveAtchison, KS 66002-1243 · (913) 367-7300

Phone(913) 367-6689

Fax(913) 360-5837

Sole ProprietorNo

Enumeration DateJune 28, 2005

Last NPPES UpdateJanuary 28, 2010

✔ NPI 1639175292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in KS · 0413701

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.

810 RAVEN HILL DRIVE, Atchison, KS 66002

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Other Identifiers 3

Medicare ID-Type Unspecified173470KS

Medicaid100098780IKS

Medicare UPIND17332KS

Other Providers at the Same Location NPPES 2

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

JON M SIEBERT MD

Family Medicine

810 RAVEN HILL DRIVE
ATCHISON, KS 66002

Atchison County (913) 367-7300

BENJAMIN H STONE MD

Surgery

810 RAVEN HILL DRIVE
ATCHISON, KS 66002

Atchison County (913) 367-7300

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 Wayne Wallace's NPI number?

The NPI number for Wayne Wallace is 1639175292. It was assigned to this individual provider in the NPPES registry on June 28, 2005.

Where is Wayne Wallace located?

Wayne Wallace practices at 810 Raven Hill Drive, Atchison, KS 66002. The listed phone number is (913) 367-6689.

What is Wayne 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 Wayne Wallace was last updated on January 28, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.