SCOTT EARL WALLACE (DO) – Student in an Organized Health Care Education/Training Program, NPI 1861074635
Student in an Organized Health Care Education/Training Program
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SCOTT EARL WALLACE (DO)
401 Matthew St
Outreach/Ferguson Building
Marietta, OH 45750
Phone: (740) 568-5669
Type: Location
106 N Elm St
Williamstown, WV 261871826
Phone: (435) 590-0835
Type: Location
106 N ELM ST
WILLIAMSTOWN, WV 261871826
Phone: (435) 590-0835
Type: Mailing
26 HOSPITAL DR FL 2
ATHENS, OH 457012471
Phone: (740) 249-4122
Fax: (740) 249-4126
Type: Location
401 MATTHEW ST
OUTREACH/FERGUSON BUILDING
MARIETTA, OH 45750
Phone: (740) 568-5669
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-08-25
PECOS data refreshed: 2026-05-27
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45750)
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