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JEFFREY LEIGH WALLACE MD NPI 1548262108


NPI Information

NPI: 1548262108
Provider Name: JEFFREY LEIGH WALLACE, MD
Classification: Surgery - 208600000X
Entity Type: Individual

PECOS Registration: Yes

Address:
411 N SECTION ST
FAIRHOPE, AL
ZIP 36532
Phone: (251) 928-9090
Get Directions

Jeffrey Leigh Wallace, MD is a surgery in Fairhope, AL with 48 years of experience. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. Jeffrey Leigh Wallace, MD NPI is 1548262108. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year:1976

The provider's business location address is:

411 N SECTION ST
FAIRHOPE, AL
ZIP 36532-649
Phone: (251) 928-9090
Fax: (251) 990-0520

The NPI 1548262108 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of skin and tissue first 20 sq cm or less (HCPCS:11042)
  • Removal of skin and tissue (HCPCS:11045)

The enumeration date for this NPI number is 8/12/2005 and was last updated on 10/10/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12083P0011XPreventive MedicineUndersea and Hyperbaric Medicine29105ALABAMANo
2208D00000XGeneral PracticeMD29105ALABAMANo
3208600000XSurgery29105ALABAMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13-187746MEDICAIDTENNESSEE
23-187746MEDICARE ID-TYPE UNSPECIFIEDTENNESSEE
3B04291MEDICARE UPIN
41548262108MEDICAIDALABAMA
51407812001MEDICAIDALABAMA
6102I028950MEDICARE PINALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.