R. Duncan Wallace, M.D., P.C.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

148121-1205 Issued in UT

Legal business name

R. DUNCAN WALLACE, M.D., P.C.

Practice address

2972 S Devonshire Cir
Salt Lake City, UT 84108-2526

Phone

(801) 355-8323

NPI assigned

Nov 20, 2012

Last updated

Apr 9, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kathy Snow

Title

Office Manager

Phone

(801) 486-7940

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Duncan Wallace, M.D.

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1134133200
  Medicare reassignment NPD

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365465600000",
    "number": "1700120334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 581065",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841581065",
            "telephone_number": "801-355-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2972 S DEVONSHIRE CIR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841082526",
            "telephone_number": "801-355-8323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. DUNCAN WALLACE, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2013-04-09",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-486-7940",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "148121-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beatriz Quiroz
• Nicole Elice Quiroz
• Daphne Alana Quist, C.S.W.
• James Quist II, LAT, ATC
• R C Halversen MD PC
• R2 Medical
• Charlyn Leslie Raaberg
• Hannah Erin Raasch, MD
• Sonja Elizabeth Raaum, MD
• Julianne Rabb, LCSW

• Psychiatry Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Psychiatry Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.