DAVID R WALLACE JR, MD, Diagnostic Radiology LAKE CHARLES, LA

Contact Information

DAVID R WALLACE JR, MD

1800 RYAN ST STE 105
LAKE CHARLES, LA 70601-6078

Phone: 337-439-4706
Fax: 337-439-8110
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Diagnostic Radiology	2085R0202X	30	Physician/Diagnostic Radiology
Student in an Organized Health Care Education/Training Program	390200000X

Indicates primary specialty

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NPI Profile & details for DAVID R WALLACE JR · (Male)

NPI #	`1265743595`
Status	Active
Credentials	MD
Entity	Individual
Enumeration date	07/01/2010
Last updated	03/12/2025 - More than a year ago
Sole proprietor ¹	No
Identifiers	CA License # A136122 LA License # MD.204718
Hospital affiliation(s)	BEAUREGARD MEMORIAL HOSPITAL - (Acute Care) 600 S PINE STREET DERIDDER, LA 70634 CHRISTUS ST PATRICK HOSPITAL - (Acute Care) 524 DR MICHAEL DEBAKEY STREET LAKE CHARLES, LA 70601 LAKE CHARLES MEMORIAL HOSPITAL - (Acute Care) 1701 OAK PARK BLVD LAKE CHARLES, LA 70601 OCHSNER MEDICAL CENTER-BATON ROUGE - (Acute Care) 17000 MEDICAL CENTER DR BATON ROUGE, LA 70816 WEST CALCASIEU CAMERON HOSPITAL - (Acute Care) 701 EAST CYPRESS STREET SULPHUR, LA 70663

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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DAVID R WALLACE JR, MD – NPI #1265743595Diagnostic Radiology

Contact Information

Specialty

Diagnostic Radiology

Student in an Organized Health Care Education/Training Program

NPI Profile & details for DAVID R WALLACE JR · (Male)

Reviews for DAVID R WALLACE JR

DAVID R WALLACE JR, MD – NPI #1265743595
Diagnostic Radiology