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

Emmett Lee Wallace, DO

Individual provider Family Medicine Physician · NPI 1215992334

Emmett Lee Wallace, DO is a Family Medicine Physician in Bettendorf, Iowa. Practices as a sole proprietor. Licensed in Iowa, Illinois and Missouri.

Licensed in
IA, IL, MO
In the registry since
2006
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1019 Broadlawn Ave
Bettendorf, IA 52722
Phone: (563) 359-1181
Fax: (563) 386-3177
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 01133 (IA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 27754 (MO)
Family Medicine Physician Taxonomy 207Q00000X · Licence 03652892 (IL)

Record details

NPI number1215992334
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 20, 2006
Last updated in NPPESJuly 22, 2011

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