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DR. LARRY CHARLES WALLIS OD
NPI 1821083585
Optometrist in Gloucester City, NJ

Active since September 19, 2005
14 N BROADWAY, GLOUCESTER CITY, NJ 08030(856) 456-3925(856) 456-4748 Get Directions Write a Review

NPPES record last updated: October 30, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Larry Charles Wallis Od NPPES

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

DR. LARRY CHARLES WALLIS OD (NPI 1821083585) is an individual optometrist in Gloucester City, New Jersey, licensed in New Jersey (270A00350300) and active in the NPI registry since September 2005.

NPPES Registry Identity

NPI1821083585
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. LARRY CHARLES WALLISCredential: OD
Location Address14 N BROADWAYGloucester City, NJ 08030-1507
Mailing AddressPo Box 93, 14 N BroadwayGloucester City, NJ 08030-0093 · (856) 456-3925 · Fax (856) 456-4748
Phone(856) 456-3925
Fax(856) 456-4748
Sole ProprietorYes
Enumeration DateSeptember 19, 2005
Last NPPES UpdateOctober 30, 2007
✔ NPI 1821083585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in NJ · 270A00350300✔ Licensed in NJ · 27T000023300
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
14 N BROADWAY, Gloucester City, NJ 08030
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Other Names 1

Other Name (5)Dr. Larry Charles Wallis

Other Identifiers 3

Medicare UPINT77821
Medicaid1695401NJ
Medicare PIN054627NJ

Other Providers at the Same Location NPPES

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

DR. LARRY CHARLES WALLIS LLC
Optometrist
14 N BROADWAY, POB93
GLOUCESTER CITY, NJ 08030
Camden County (856) 456-3925

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 Larry Wallis's NPI number?

The NPI number for Larry Wallis is 1821083585. It was assigned to this individual provider in the NPPES registry on September 19, 2005. The provider is also known as Dr. Larry Charles Wallis.

Where is Larry Wallis located?

Larry Wallis practices at 14 N Broadway, Gloucester City, NJ 08030. The listed phone number is (856) 456-3925.

What is Larry Wallis's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

When was this NPI record last updated?

The NPPES record for Larry Wallis was last updated on October 30, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.