What is Wallace Green's NPI number?

Wallace Green's National Provider Identifier (NPI) is 1306979059, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Wallace Green's specialty?

Wallace Green is listed in the NPPES registry with a primary specialty of Neurology Physician (Allopathic & Osteopathic Physicians).

Where is Wallace Green located?

Wallace Green's practice location on file with NPPES is 1275 Highway 54 W, Fayetteville, GA 30214-4549.

What is Wallace Green's phone number?

The practice phone number listed in the NPPES registry for Wallace Green is (770) 719-2965.

Is Wallace Green's NPI active?

Yes — Wallace Green's NPI (1306979059) is active in the NPPES registry as of the last update on 2007-07-08.

IndividualActive

Wallace Green, PAC

NPI 1306979059 · Neurology Physician · Fayetteville, GA

Wallace Green, PAC is a Neurology Physician provider in Fayetteville, GA (NPI 1306979059).

Provider details

NPI number: 1306979059
Entity type: Individual
Primary specialty: Neurology PhysicianAllopathic & Osteopathic Physicians
Credential: PAC
Sex: Male
Sole proprietor: No
License: 001827 (GA)

Specialties & taxonomies

Neurology PhysicianPrimary2084N0400XLicense 001827 (GA)
Allopathic & Osteopathic Physicians

Profile Score

Detailed profile(90/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
19 yrs in NPPES registry
Profile completeness38% of score
100% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

1275 Highway 54 W

Ste.105

Fayetteville, GA 30214-4549

Phone: (770) 719-2965

Fax: (770) 719-2963

Street-level locationGet directions

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Mailing address