William R Wallace, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

35 044677 Issued in OH

Practice address

2600 6TH St SW
Radiology Associates of Canton, Inc
Canton, OH 44710-1702

Phone

(330) 363-2842

Fax

(330) 580-5536

NPI assigned

Dec 1, 2005

Last updated

Jan 5, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Canton Aultman Emergency Physicians Inc

  • Emergency Medicine Physician
  • Canton, OH
  • NPI 1801832381
  NPD
• Stark County Pathologists Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Canton, OH
  • NPI 1194030437
  NPD
• Community Health Care Inc.

  • Family Medicine Physician
  • Canal Fulton, OH
  • NPI 1114902137
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1447234703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 72384",
            "address_2": "RADIOLOGY ASSOCIATES OF CANTON, INC.",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44192",
            "telephone_number": "888-686-1837",
            "fax_number": "330-686-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 6TH ST SW",
            "address_2": "RADIOLOGY ASSOCIATES OF CANTON, INC",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-363-2842",
            "fax_number": "330-580-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "OH",
            "license": "35 044677",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35 044677",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "OH",
            "license": "35 044677",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0558178",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00417325",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Wallace
• Lauren Elizabeth Wallace, LPCC
• Paige Wallace, LPCC-S, CCATP
• Stephanie R Wallace, COTA/L
• Stephen James Wallace, LPCC
• Susan Waller
• Carlos D Walls
• Lindsey Walls, LPC
• Addison Walsh
• Edward J. Walsh, M.D.

• Diagnostic Radiology Physician in Canton, OH
• Providers in Canton, OH by specialty
• Diagnostic Radiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.