Dr James Howard Wallace, MD | |
1600 22nd Ave Fl 3, Meridian, MS 39301 | |
(601) 693-1055 | |
(601) 482-5312 |
Full Name | Dr James Howard Wallace |
---|---|
Gender | Male |
Speciality | Urology |
Experience | 12 Years |
Location | 1600 22nd Ave Fl 3, Meridian, Mississippi |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1881794162 | NPI | - | NPPES |
T-2618 | Other | MS | STATE MEDICAL BOARD |
487562499A | Medicaid | GA | |
08128741 | Medicaid | MS | |
G13318 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | T-2618 (Mississippi) | Secondary |
208800000X | Urology | 25034 (Mississippi) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Anderson Regional Medical Ctr | Meridian, MS | Hospital |
Neshoba County General Hospital | Philadelphia, MS | Hospital |
Rush Foundation Hospital | Meridian, MS | Hospital |
Anderson Regional Medical Center South Campus | Meridian, MS | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Anderson Physician Alliance Inc | 3274727318 | 9 |
Entity Name | State Of Mississippi - University Of Mississippi Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1154317527 PECOS PAC ID: 1850293036 Enrollment ID: O20090414000575 |
Entity Name | Anderson Physician Alliance Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760798227 PECOS PAC ID: 3274727318 Enrollment ID: O20101102000877 |
Mailing Address | Practice Location Address |
---|---|
Dr James Howard Wallace, MD 2500 N State St, Jackson, MS 39216-4500 Ph: (601) 984-5101 | Dr James Howard Wallace, MD 1600 22nd Ave Fl 3, Meridian, MS 39301 Ph: (601) 693-1055 |
Stanley A. Wade Jr., M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 1800 12th St, Meridian, MS 39301 Phone: 601-703-9223 Fax: 601-703-9405 | |
Robert E Dilworth, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 1600 22nd Ave, Medical Towers 3, 3rd Fl, Meridian, MS 39301 Phone: 601-693-1055 Fax: 601-482-5312 | |
Richard M. Vise, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 1800 12th St, Meridian, MS 39301 Phone: 601-703-9223 Fax: 601-703-9405 | |
Mark T Phillips, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 1600 22nd Ave, Medical Towers Iii, 3rd Floor, Meridian, MS 39301 Phone: 601-693-1055 Fax: 601-482-5312 |