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

Emmett Lee Wallace, DO

Individual provider Family Medicine Physician · NPI 1215992334

Emmett Lee Wallace, DO is a Family Medicine Physician in Bettendorf, Iowa. Practices as a sole proprietor. Licensed in Iowa, Illinois and Missouri.

Licensed in
IA, IL, MO
In the registry since
2006
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1019 Broadlawn Ave
Bettendorf, IA 52722
Phone: (563) 359-1181
Fax: (563) 386-3177
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 01133 (IA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 27754 (MO)
Family Medicine Physician Taxonomy 207Q00000X · Licence 03652892 (IL)

Record details

NPI number1215992334
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 20, 2006
Last updated in NPPESJuly 22, 2011
Mailing address1019 Broadlawn Avenue, Bettendorf, IA 52722

Other providers in Bettendorf