Donetta Wallace, P.A.-C

NPI 1417958828 · on the registry since 2005

Practice

Address: 336 N Mayo Trl
Paintsville, KY 41240
Phone: (606) 789-8666
Fax: (606) 788-0253
Organisation at this address: Doctors Office Pllc
Ashland Hospital Corporation
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 363A00000X
363A00000X
Also registered as: 363AM0700X
Licence states on file: KY
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2022-02-01

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kentucky