Dr Robert D Wallace, MD | |
1068 Cresthaven Rd Ste 500, Memphis, TN 38119 | |
(901) 866-8525 | |
Not Available |
Full Name | Dr Robert D Wallace |
---|---|
Gender | Male |
Speciality | Plastic And Reconstructive Surgery |
Experience | 40 Years |
Location | 1068 Cresthaven Rd Ste 500, Memphis, Tennessee |
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 |
---|---|---|---|
1023075637 | NPI | - | NPPES |
130322001 | Medicaid | AR | |
00118676 | Medicaid | MS | |
3804973 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2086S0122X | Surgery - Plastic And Reconstructive Surgery | 27658 (Tennessee) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Wallace Plastic Surgery Group, Pllc | 0749664076 | 2 |
Entity Name | Ut Medical Group, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780676650 PECOS PAC ID: 3173435369 Enrollment ID: O20031105000384 |
Entity Name | St Jude Childrens Research Hospital Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306335088 PECOS PAC ID: 7315133444 Enrollment ID: O20180821000139 |
Entity Name | Wallace Plastic Surgery Group, Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497473557 PECOS PAC ID: 0749664076 Enrollment ID: O20220905000477 |
Mailing Address | Practice Location Address |
---|---|
Dr Robert D Wallace, MD 1407 Union Ave Ste 700, Memphis, TN 38104-3641 Ph: (901) 866-8622 | Dr Robert D Wallace, MD 1068 Cresthaven Rd Ste 500, Memphis, TN 38119 Ph: (901) 866-8525 |
Leonard Harvey Hines, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 6005 Park Ave, Suite 821-b, Memphis, TN 38119 Phone: 901-726-1056 Fax: 901-726-5867 | |
William Leslie Hickerson, MD Surgery Medicare: Medicare Enrolled Practice Location: 890 Madison Ave, Suite Tg032, Memphis, TN 38103 Phone: 901-448-2579 Fax: 901-448-2602 | |
Dr. Dan Huff Shell Iii, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1068 Cresthaven Rd Ste 200, Memphis, TN 38119 Phone: 901-761-4844 Fax: 901-761-6929 | |
Randall William Franz, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1325 Eastmoreland Ave Ste 365, Memphis, TN 38104 Phone: 901-272-6018 Fax: 901-201-4203 | |
Dr. Christine T Mroz, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 6005 Park, #700, Memphis, TN 38119 Phone: 901-527-3391 Fax: 901-578-3969 | |
Miriam Wing San Tsao, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1211 Union Ave Suite 300, Memphis, TN 38104 Phone: 901-516-0792 Fax: 901-266-6415 |