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Contact Information

ROBERT WALLEY
415 S 28TH AVE
HATTIESBURG, MS39401-7246
 Phone: 601-268-5650
 Fax: 601-579-5240
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
 

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for ROBERT WALLEY · (Male)

NPI Number 1588047567
Status Active
Credentials
Entity Individual
Enumeration date 07/08/2015
Last updated 01/05/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • MS License # 30801
  • TX License # S8672
  • TX Medicaid 417472401
  • TX Other 1J2146 MEDICARE
Hospital affiliation(s)
  • BAPTIST ST ANTHONYS HEALTH SYSTEM-BAPTIST CAMPUS - (Acute Care)
    1600 WALLACE BLVD
    AMARILLO, TX 79106
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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