Wallace Physician Services Llc in Cincinnati, OH

Wallace Physician Services Llc is a medicare enrolled primary clinic (Internal Medicine) in Cincinnati, Ohio. The current practice location for Wallace Physician Services Llc is 1577 Goodman Ave Ste A, Cincinnati, Ohio. For appointments, you can reach them via phone at (513) 403-3762. The mailing address for Wallace Physician Services Llc is Po Box 40535, Cincinnati, Ohio and phone number is (859) 384-9045.

Wallace Physician Services Llc is licensed to practice in Ohio (license number 35-076674). The clinic also participates in the medicare program and its NPI number is 1144527870. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (513) 403-3762.

Contact Information

	Wallace Physician Services Llc
	1577 Goodman Ave Ste A Cincinnati OH 45224-1044
	(513) 403-3762
	(513) 521-6403

Map and Direction

Primary Care Clinic Profile

Full Name	Wallace Physician Services Llc
Speciality	Internal Medicine
Location	1577 Goodman Ave Ste A, Cincinnati, Ohio
Authorized Official Name and Position	Waymon L Wallace (PRESIDENT)
Authorized Official Contact	5136749601
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Wallace Physician Services Llc Po Box 40535 Cincinnati OH 45240-0535 Ph: (859) 384-9045	Wallace Physician Services Llc 1577 Goodman Ave Ste A Cincinnati OH 45224-1044 Ph: (513) 403-3762

NPI Details:

NPI Number	1144527870
Provider Enumeration Date	02/15/2011
Last Update Date	07/21/2022

Medicare PECOS Information:

Medicare PECOS PAC ID	2062695141
Medicare Enrollment ID	O20171024002033

Medical Identifiers

Medical identifiers for Wallace Physician Services Llc such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1144527870	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	35-076674 (Ohio)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Wallace Physician Services Llc acts as a billing entity for following providers:

Provider Name	Waymon Leland Wallace
Provider Type	Practitioner - Internal Medicine
Provider Identifiers	NPI Number: 1841213667 PECOS PAC ID: 7315916335 Enrollment ID: I20040927001175

Reviews and Comments

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Wallace Physician Services Llc - Medicare Primary Care in Cincinnati, OH