DR. DOUGLAS CHARLES WALLACE M.D.
NPI 1851470033
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Lafayette, IN
- Individual
- Male
- Thoracic Surgery (Cardiothoracic Vascula...
About DOUGLAS WALLACE
This page provides the complete NPI Profile along with additional information for Douglas Wallace, a provider established in Lafayette, Indiana with a medical specialization in Thoracic Surgery (cardiothoracic Vascular Surgery). The healthcare provider is registered in the NPI registry with number 1851470033 assigned on November 2006. The practitioner's primary taxonomy code is 208G00000X with license number 01071946A (IN). The provider is registered as an individual and his NPI record was last updated 14 years ago.
- NPI
- 1851470033 Verify this NPI
- Provider Name
- DR. DOUGLAS CHARLES WALLACE M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3900 ST FRANCIS WAY STE 201 LAFAYETTE, IN 47905
- Location Phone
- (765) 446-7981
- Location Fax
- (765) 446-7982
- Mailing Address
- 3900 ST FRANCIS WAY STE 201 LAFAYETTE, IN 47905
- Mailing Phone
- (765) 446-7981
- Mailing Fax
- (765) 446-7982
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-06-2006
- Last Update Date
- 12-19-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Thoracic Surgery (Cardiothoracic Vascular Surgery)
- Taxonomy Code
- 208G00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 01071946A
- License State
- IN
- Taxonomy Description
- A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | G66727 (CA) |
| 2 | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 036-101410 (IL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 256510001 | MEDICARE PIN (08) | IL | |
| 036112410 | MEDICAID (05) | IL |
Reviews for DR. DOUGLAS CHARLES WALLACE M.D.
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Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
LAFAYETTE, IN 47905
LAFAYETTE, IN 47905
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1851470033, enumerated as an "individual" on November 06, 2006.
The provider is located at 3900 ST FRANCIS WAY STE 201 LAFAYETTE, IN 47905 and the phone number is (765) 446-7981.
Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
