MICHAEL TAYLOR WALLACE (NPI# 1376922948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376922948 |
| Entity Type | Individual |
| Full Name | MICHAEL TAYLOR WALLACE |
| Credential | M.D. |
| Practice Address |
930 Madison Ave Ste 200 Memphis TN 38103 |
| Mailing Address |
1407 Union Ave Ste 700 Memphis TN 38104-3641 |
| Practice Telephone | 9014486650 |
| Mailing Telephone | 9018668003 |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2019-06-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 59163 | TN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1250 E Marshall St # 980438, Richmond, VA 232985051 | 8048285208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417014424 | Michael J Wallace | Dentist | 1600 E 19th St, Suite 301, Edmond, OK 73013-6622 | 2007-01-02 |
| 1518042696 | Michael J. Wallace | Dentist | 1263 High St, Auburn, CA 95603-5016 | 2006-10-26 |
| 1124127279 | Michael James Wallace | Dentist | 1195 W Mason St, Green Bay, WI 54303-2045 | 2006-09-22 |
| 1679585038 | Michael Patrick Wallace | Dentist | 9225 Manchester Rd, Suite 101, Saint Louis, MO 63144-2640 | 2006-08-13 |
| 1467438937 | Michael Lloyd Wallace | Pathology | 522 Alpha Dr, Pittsburgh, PA 15238-2912 | 2005-12-16 |
| 1609356864 | Michael Wallace | Physical Therapy Assistant | 5455 Knickerbocker Rd, San Angelo, TX 76904-7711 | 2018-08-17 |
| 1225579899 | Michael Wallace | Counselor | 500 Allerton St, Second Floor, Redwood City, CA 94063-1519 | 2017-03-16 |
| 1194029777 | Michael T Wallace | Nurse Practitioner | 9900 Bren Rd E, Minnetonka, MN 55343-9664 | 2010-12-22 |
| 1003116658 | Michael Eugene Wallace | Psychologist | 201 E Liberty St, Suite 2, Ann Arbor, MI 48104-2118 | 2010-10-29 |
| 1003057852 | Michael Alan Wallace | Nurse Practitioner | 8210 Louisiana Blvd Ne, Suite C, Albuquerque, NM 87113-1761 | 2009-03-07 |
| Street Address |
930 MADISON AVE STE 200 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063473387 | Penny Asbell | Ophthalmology | 930 Madison Ave Ste 200, Memphis, TN 38163 | 2006-03-28 |
| 1699138222 | Jessica Lam | Optometrist | 930 Madison Ave Ste 200, Memphis, TN 38103-3452 | 2016-03-31 |
| 1619388691 | Daniel Ofori | Ophthalmology | 930 Madison Ave Ste 200, Memphis, TN 38103-3452 | 2014-05-13 |
| 1871933473 | Robert Charles Binkley | Optometrist | 930 Madison Ave Ste 200, Memphis, TN 38103-3452 | 2013-06-27 |
| 1265774673 | Sara Nicole Reggie | Ophthalmology | 930 Madison Ave Ste 200, Memphis, TN 38103 | 2013-03-24 |
| 1700148053 | Kourtney Henderson Houser | Ophthalmology | 930 Madison Ave Ste 200, Memphis, TN 38103 | 2012-06-12 |
| 1487829347 | Brian Montgomery Jerkins | Ophthalmology | 930 Madison Ave Ste 200, Memphis, TN 38163 | 2008-04-22 |
| 1093987893 | Brian T Fowler | Ophthalmology | 930 Madison Ave Ste 200, Memphis, TN 38103-3452 | 2008-04-01 |
| 1477636033 | Elliott Makary Kanner | Ophthalmology | 930 Madison Ave Ste 200, Memphis, TN 38103 | 2006-10-24 |
| 1104883701 | Matthew W Wilson | Ophthalmology | 930 Madison Ave Ste 200, Memphis, TN 38163 | 2006-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619505724 | Michelle Lynn Esposito | Dietitian, Registered | 1st Floor Research Center - 50 North Dunlap St, Memphis, TN 38103 | 2020-04-01 |
| 1962030221 | Allison Burge Clayton | Dietitian, Registered | 50 N Dunlap, Nutrition Therapy Dept, 1st Floor Research Tower, Memphis, TN 38103 | 2020-03-31 |
| 1093375420 | Radar Ems, LLC | Social Worker | 50 S. B.b. King Blvd, Suite 350, Memphis, TN 38103 | 2019-06-18 |
| 1528529021 | Denise Andrews Matthews | Nursing Care | 342 Island Dr #105, Memphis, TN 38103 | 2019-03-27 |
| 1881160059 | Christopher Paul Hernandez | Nurse Practitioner | 877 Jeffeon Ave, Memphis, TN 38103 | 2018-10-15 |
| 1194245712 | Cameron Waters Clinard | Optometrist | 127 Isle Creek Dr, Memphis, TN 38103 | 2017-06-24 |
| 1750732582 | Amanda Leigh Eaves | Nurse Practitioner | 364 S Front St Ste 201, Memphis, TN 38103 | 2016-06-22 |
| 1417304569 | John Clark Shell | Family Medicine | 150 Harbor Creek Dr, Memphis, TN 38103 | 2016-05-18 |
| 1750753695 | Tomisha V. Byard | Nurse Practitioner | 718 Habor Bend Road, Memphis, TN 38103 | 2015-10-29 |
| 1053795179 | Melissa Anne Wilkes | Social Worker | 1240 Harbor River Drive, Memphis, TN 38103 | 2015-07-18 |
| Find all providers in zip 38103 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447606454 | Stephen Dryden | Ophthalmology | 930 Madison Ave Ste 470, Memphis, TN 38103-7400 | 2016-05-09 |
| 1609185891 | Duncan Eye Pllc | Ophthalmology | 653 S Willett St, Memphis, TN 38104-4932 | 2010-10-05 |
| 1275842197 | Kathleen Shirley Stern | Ophthalmology | 655 S Riverside Dr Apt 1103, Memphis, TN 38103-4615 | 2010-09-27 |
| 1083865232 | Memphis Retina Pllc | Ophthalmology | 1264 Wesley Dr Ste 302, Memphis, TN 38116-6445 | 2008-10-07 |
| 1205021227 | Clifford W Sims Md PC | Ophthalmology | 1407 Union Ave Ste 1003, Memphis, TN 38104-3678 | 2007-09-12 |
| 1235335118 | Shiva Bohn | Ophthalmology | 930 Madison Ave #400, Memphis, TN 38103 | 2007-06-26 |
| 1578684007 | Philip Marvin Furr | Ophthalmology | 555 Perkins Ext, Ste 430, Memphis, TN 38117-4410 | 2007-04-02 |
| 1538216239 | William C Hurd | Ophthalmology | 220 S Claybrook St Ste 101, Memphis, TN 38104-3538 | 2007-01-04 |
| 1023170925 | Clifford William Sims | Ophthalmology | 1407 Union Ave Ste 901, Memphis, TN 38104-3672 | 2006-12-15 |
| 1487724498 | Thomas Pratt | Ophthalmology | 5169 Wheelis Dr, Memphis, TN 38117-4519 | 2006-11-08 |
| Find all providers in MEMPHIS | ||||
Please comment or provide details below to improve the information on MICHAEL TAYLOR WALLACE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.