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Contact Information

MCKENZIE WALLACE, MD
M263 MEDICAL SCIENCE BUILDING ONE HOSPITAL DRIVE
COLUMBIA, MO65212-0001
 Phone: 573-882-3014
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for MCKENZIE WALLACE · (Female)

NPI # 1548019946
Status Active
Credentials MD
Entity Individual
Enumeration date 05/16/2024
Last updated 06/24/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MO License # 2024023604
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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