John Hugh G Wallace Jr., PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810002367 Issued in VA

Practice address

Naval Ambulatory Care Center
Route 12, BLDG 449, Attn: Professional Affairs
Groton, CT 06349-5600

Phone

(860) 694-2377

Fax

(860) 694-2590

NPI assigned

Nov 15, 2005

Last updated

Jul 13, 2026By 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 1

Addresses

Other names 1

• Mr. Hugh G Wallace Jr. Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

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    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1972585156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL AMBULATORY CARE CENTER",
            "address_2": "ROUTE 12, BLDG 449, ATTN: PROFESSIONAL AFFAIRS",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495600",
            "telephone_number": "860-694-2377",
            "fax_number": "860-694-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL AMBULATORY CARE CENTER",
            "address_2": "ROUTE 12, BLDG 449, ATTN: PROFESSIONAL AFFAIRS",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495600",
            "telephone_number": "860-694-2377",
            "fax_number": "860-694-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JOHN",
        "middle_name": "HUGH G",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HUGH",
            "last_name": "WALLACE",
            "middle_name": "G",
            "prefix": "MR.",
            "suffix": "JR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Brian Walton, O.D.
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• Nicholas Gregory Watters, SUB IDC
• Laura Anne Watts, M.D.
• Kenneth Aloka Waugh, IDC

• Clinical Psychologist in Groton, CT
• Providers in Groton, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.