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General NPI Number Information
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NPI Number | 1821012998
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Entity Type | Individual
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Provider Name | JAMES CALEB WALLWORK M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1223 HATCHER LN
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City | COLUMBIA
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State | TN
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Zip | 38401-3531
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Country | US
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Telephone | 931-840-4200
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Fax | 931-840-5757
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Provider Business Mailing Address
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Address Line | 8237 ALAMO RD
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City | BRENTWOOD
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State | TN
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Zip | 37027-7311
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Country | US
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Telephone | 615-370-3500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 05380
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License Number State | TN
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