Thomas Jeffrey Wallace, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in West Columbia, South Carolina. His current practice location is
145 Sunset Ct Ste 100, West Columbia, South Carolina. You can reach out to his office (for appointments etc.) via phone at
(803) 739-3491.
Thomas Jeffrey Wallace is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1730871567.
Physician's Profile
Full Name | Thomas Jeffrey Wallace |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 145 Sunset Ct Ste 100, West Columbia, South Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1730871567
- Provider Enumeration Date: 05/22/2023
- Last Update Date: 01/30/2025
Medicare PECOS Information:
- PECOS PAC ID: 1850752239
- Enrollment ID: I20230801004187
Medical Identifiers
Medical identifiers for Thomas Jeffrey Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1730871567 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 89976 (South Carolina) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Thomas Jeffrey Wallace is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Thomas Jeffrey Wallace, DO 145 Sunset Ct Ste 100, West Columbia, SC 29169-2429 Ph: (803) 739-3491 | Thomas Jeffrey Wallace, DO 145 Sunset Ct Ste 100, West Columbia, SC 29169-2429 Ph: (803) 739-3491 |
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