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

Mr. Mark James Wallace, DOCTOROFPHARMACY

Individual provider Pharmacist · NPI 1205110434

Mr. Mark James Wallace, DOCTOROFPHARMACY is a Pharmacist in Edmond, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2011.

Licensed in
OK
In the registry since
2011
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Practice location Address checks out

301 S Sante Fe Ave
Edmond, OK 73003
Phone: (405) 330-6093
Fax: (405) 330-6153
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 11913 (OK)

Record details

NPI number1205110434
Entity typeIndividual (Type 1)
GenderMale
Credentials DOCTOROFPHARMACY
Sole proprietorNo
NPI enumeratedOctober 6, 2011
Last updated in NPPESOctober 6, 2011

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