Wallace Dale Prophet
Medical Specialty
Professional ID
- NPI: 1942294426
- PECOS ID: 9638270200
- Enrollment ID: I20160614000607
- Credential(MD, DO, DPM):
- Medical School: University Of Alabama School Of Medicine
- Medical School Graduation Year: 1978
Hospital Service
- Hospital CCN1: 270051
- Business Name (LBN)1: Kalispell Regional Medical Center
- Hospital CCN2: 270087
- Business Name (LBN)2: The Healthcenter
- Hospital CCN3: 271323
- Business Name (LBN)3: Clark Fork Valley Hospital
- Hospital CCN4: 271336
- Business Name (LBN)4: North Valley Hospital
- Hospital CCN5: 271343
- Business Name (LBN)5: Providence St Joseph Medical Center
Medical Practices
- Organization Name: Kalispell Regional Medical Center Inc
- Group Practice ID assigned by PECOS: 5294644381
- Number of Group Practice member: 235
Location
- Address1: 310 Sunnyview Ln
- Address2:
- City: Kalispell
- State: Montana
- Zip Code: 59901
- Phone Number: (406)751-5310
Location
- Address1: 350 Heritage Way
- Address2: Suite 2100
- City: Kalispell
- State: Montana
- Zip Code: 59901
- Phone Number: (406)257-8992
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
- Used Electronic health record (EHR): Yes