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

Douglas W Wallace, MD

Individual provider Diagnostic Radiology Physician · NPI 1083608053

Douglas W Wallace, MD is a Diagnostic Radiology Physician in Columbus, Georgia. Licensed in Georgia. Registered with an NPI since 2005.

Licensed in
GA
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2300 Manchester Expy Ste A001
Columbus, GA 31904-6802
Phone: (706) 257-7700
Fax: (706) 257-7708
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 014966 (GA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 14966 (GA)

Record details

NPI number1083608053
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 7, 2005
Last updated in NPPESJuly 27, 2015
Mailing addressP.O. Box 9145, Columbus, GA 31908-9145

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