NPI age
20 years
Enumerated 2005-09-07
● Active
Type 1 · Individual
Douglas W Wallace, MD
Wallace is 1 of 35 radiology providers in Columbus and 1 of 1280 in Georgia.
Primary specialty
Radiology
Plus 1 subspecialty
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2015-07-27
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1280 active radiology providers in Georgia.
NPI age
20 years
≈ at median (19 yr)
State licenses
1 state
21% of peers hold multiple states
Subspecialties
0
38% of peers hold subspecialties
NPI lifetime · 2005 → 2026
2005-09Enumerated in NPPES
2005
2026
Where they practice
Practice location
2300 Manchester Expy, Ste A001
Columbus, GA 319046802
Mailing address
P.o. Box 9145
Columbus, GA 319089145
Specialties
-
Radiology PrimaryA radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003139318A | |
| 05 (AL) | 141177 | |
| 01 (GA) | 202I307506 | MEDICARE PTAN |
Practice context
Part of a multi-provider practice. 95 other active providers share this practice address in NPPES.
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