Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Richard G Wallis MD PA

Organization Anesthesiology Physician · NPI 1801169412

Richard G Wallis MD PA is an Anesthesiology Physician in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2012.

Licensed in
FL
In the registry since
2012
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone: (904) 421-2119
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence ME37752 (FL)

Record details

NPI number1801169412
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Wallis — President · (904) 421-2119
NPI enumeratedFebruary 13, 2012
Last updated in NPPESFebruary 13, 2012
Mailing address6255 Lake Gray Blvd, Suite 1, Jacksonville, FL 32244-7502

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