Aaron J Wallace, MD,PLLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

AARON J WALLACE, MD,PLLC

Practice address

628 Hospital Dr
Suite E
Mountain Home, AR 72653-2953

Phone

(870) 424-4710

Fax

(870) 424-4780

NPI assigned

Aug 20, 2009

Last updated

Jun 24, 2010By 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

Dr. Aaron J Wallace, M.D.

Title

Owner

Phone

(870) 424-4710

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1841422003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "479-968-4273",
            "fax_number": "479-968-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 HOSPITAL DR",
            "address_2": "SUITE E",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532953",
            "telephone_number": "870-424-4710",
            "fax_number": "870-424-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AARON J WALLACE, MD,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2010-06-24",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-424-4710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179058002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5G172",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Orthopaedic Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.