National Provider Identifier
Wallace E Johnson, MD
Wallace E Johnson, MD is listed in the NPPES registry with a primary specialty of Internal Medicine Physician in Fairport, NY and a listed phone number of (585) 602-2300.
Profile Overview
- NPI
- 1902833619
- Provider Type
- Individual
- Primary Specialty
- Internal Medicine Physician
- Enumeration Date
- June 27, 2006
- Last Updated
- July 03, 2023
Practice Location
- 800 Ayrault RD Ste 200
- Fairport, NY 14450-8941
Phone: (585) 602-2300
Specialties
- Internal Medicine Physician (207R00000X)
Endpoints
- wjohnson4289@direct.urmc.rochester.edu
Direct Messaging Address | Direct | Other | Rochester, NY 14642
Full Record
- NPI
- 1902833619
- Entity Type
- Individual
- Last Name
- Johnson
- First Name
- Wallace
- Middle Name
- E
- Credential
- MD
- Mailing Street Address
- 800 Ayrault RD Ste 200
- Mailing City
- Fairport
- Mailing State
- NY
- Mailing ZIP Code
- 14450-8941
- Mailing Country
- US
- Mailing Phone
- (585) 602-2300
- Mailing Fax
- (585) 425-2750
- Practice Street Address
- 800 Ayrault RD Ste 200
- Practice City
- Fairport
- Practice State
- NY
- Practice ZIP Code
- 14450-8941
- Practice Country
- US
- Practice Phone
- (585) 602-2300
- Practice Fax
- (585) 425-2750
- Enumeration Date
- June 27, 2006
- Last Updated
- July 03, 2023
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Internal Medicine Physician (207R00000X)
- Other Identifiers
- 01688146 (NY)