Provider Demographics
NPI:1093101107
Name:NOZILE, WALLACE RAMSEY (MD)
Entity Type:Individual
Prefix:DR
First Name:WALLACE
Middle Name:RAMSEY
Last Name:NOZILE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7300 RANCH ROAD 2222, BUILDING 1, STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730
Mailing Address - Country:US
Mailing Address - Phone:512-628-0465
Mailing Address - Fax:512-628-0465
Practice Address - Street 1:110 EAGLES WALK
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6333
Practice Address - Country:US
Practice Address - Phone:770-251-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2023-03-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME139741207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery