Jeffrey L Wallace (NPI# 1548262108, PAC ID# 7719934769) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1548262108 |
| PAC ID by PECOS | 7719934769 |
| Professional Enrollment ID | I20100202000687 |
| Full Name | Jeffrey L Wallace |
| Address |
411 N Section St Suite 1010 Fairhope AL 36532-2649 |
| Phone Number | 2519289090 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE |
| Graduation Year | 1976 |
| Primary Specialty | GENERAL SURGERY |
| Secondary Specialties | PERIPHERAL VASCULAR DISEASE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 010083 | SOUTH BALDWIN REGIONAL MEDICAL CENTER |
| 010100 | THOMAS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 411 N Section St, Suite 1010, Fairhope, AL 36532-2649 | 2519289090 |
| Street Address |
411 N SECTION ST SUITE 1010 |
| City | FAIRHOPE |
| State | AL |
| Zip | 36532-2649 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James Wilder Iii | Optometry | Bay Eyes Cataract and Laser Center Inc | 411 N Section St, Fairhope, AL 36532-2649 |
| Peter Zloty | Ophthalmology | Bay Eyes Cataract and Laser Center Inc | 411 N Section St, Fairhope, AL 36532-2649 |
| Julia Centanni Ellison | Family Medicine | Alabama Providence Healthcare Services | 411 N Section St, Fairhope, AL 36532-2649 |
| Kelvin Paul Mcdaniel | Ophthalmology | Bay Eyes Cataract and Laser Center Inc | 411 N Section St, Fairhope, AL 36532-2649 |
| Ronald Leon Gross | Ophthalmology | Bay Eyes Cataract and Laser Center Inc | 411 N Section St, Fairhope, AL 36532-2649 |
| William R Staggers | Plastic and Reconstructive Surgery | 411 N Section St, Fairhope, AL 36532-2649 | |
| Pamela Kim Phillips | Dermatology | Tarantola Dermatology Inc | 411 N Section St, Suite 301, Fairhope, AL 36532-2649 |
| Charles B Smith | General Surgery | 411 N Section St, Suite 101, Fairhope, AL 36532-2649 | |
| Amy M Christmas | Ophthalmology | Bay Eyes Cataract and Laser Center Inc | 411 N Section St, Fairhope, AL 36532-2649 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cameron Townsend Corte | Family Medicine | Fairhope Family Medicine, LLC | 21875 State Hwy 98, Fairhope, AL 36532 |
| Lea T Collins | Nurse Practitioner | Fairhope Family Medicine, LLC | 21875 State Hwy 98, Fairhope, AL 36532 |
| Regan M Andrade | Family Medicine | Fairhope Family Medicine, LLC | 21875 State Hwy 98, Fairhope, AL 36532 |
| Allan David Mills | Psychiatry | 761 B Middle St, Fairhope, AL 36532-1715 | |
| Sarah Gonzalez | Nurse Practitioner | Family Practice Associates of Montrose, Pa | 770 Middle St B, Fairhope, AL 36532-1766 |
| John J Broderick Cantwell | Psychiatry | 770 Middle St, Fairhope, AL 36532-1766 | |
| Frances T Fuller | Nurse Practitioner | Family Practice Associates of Montrose, Pa | 770 Middle St B, Fairhope, AL 36532-1766 |
| Stephen E Winston | Family Medicine | Family Practice Associates of Montrose, Pa | 770 Middle St B, Fairhope, AL 36532-1766 |
| Craig M Dowden | Family Medicine | Family Practice Associates of Montrose, Pa | 770 Middle St B, Fairhope, AL 36532-1766 |
| Karen Lynne Adams | Nurse Practitioner | Family Practice Associates of Montrose, Pa | 770 Middle St B, Fairhope, AL 36532-1766 |
| Find all physicians in zip 36532 | |||
| City | FAIRHOPE |
| Zip Code | 36532 |
| Specialty | GENERAL SURGERY |
| City + Specialty | FAIRHOPE + GENERAL SURGERY |
Please comment or provide details below to improve the information on Jeffrey L Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.