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

John Wallace Sr., IDC

Individual provider Independent Duty Corpsman · NPI 1316926066

John Wallace Sr., IDC is an Independent Duty Corpsman in Norfolk, Virginia. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

300 E Main St Ste 1000
Norfolk, VA 23510-1753
Phone: (757) 628-4347
Show map & directions

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

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X

Record details

NPI number1316926066
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorNo
NPI enumeratedJanuary 11, 2006
Last updated in NPPESJuly 13, 2026
Mailing address235 Jonathans Way, Suffolk, VA 23434-9153

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