Brent E. Wallace, MD
Family Medicine · Roy, UT
UnclaimedMDNPI 1124136221
- Primary taxonomy
- 207Q00000X
- Enumerated
- 2006-08-28
- Practice location
- Roy, UT
- Last NPPES update
- 2008-07-10
State licenses
- UT · Physician · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.