NPI Index

HAILY WALLACE, MD

Family Medicine

Active Individual
NPI: 1679839534

Practice Address

402 E MIEL DE LUNA AVE
PMG AT DR DAN C TRIGG MEMORIAL HOSPITAL
Tucumcari, NM 88401

Phone: (575) 461-7100

Specialties

Specialty Code Primary License
Family Medicine 207Q00000X Yes MD2014-0895 (NM)
Student in an Organized Health Care Education/Training Program 390200000X No -

Frequently Asked Questions

NPI 1679839534 is the National Provider Identifier for HAILY WALLACE, MD, a Family Medicine provider located in Tucumcari, NM. This NPI was enumerated on April 5, 2012.
HAILY WALLACE, MD practices at 402 E MIEL DE LUNA AVE, PMG AT DR DAN C TRIGG MEMORIAL HOSPITAL, Tucumcari, NM 88401.

Quick Facts

NPI
1679839534
Type
Individual
Enumerated
Apr 5, 2012
Last Updated
Jun 18, 2015

Nearby Providers

Same Specialty