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

Individual provider Surgical Technologist · NPI 1598824096

Alvin Joseph Wallace, CSA is a Surgical Technologist in Edgewood, Kentucky. Practices as a sole proprietor. Licensed in Kentucky.

Licensed in
KY
In the registry since
2006
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Practice location Address checks out

20 Medical Village Dr Ste 338
Edgewood, KY 41017-5414
Phone: (859) 341-2802
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Technologist (primary) Taxonomy 246ZS0410X (KY)

Record details

NPI number1598824096
Entity typeIndividual (Type 1)
GenderMale
Credentials CSA
Sole proprietorYes
NPI enumeratedDecember 8, 2006
Last updated in NPPESJuly 8, 2007