Robert D Wallace (NPI# 1023075637, PAC ID# 6608068234) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PLASTIC AND RECONSTRUCTIVE SURGERY.
| Nation Provider ID (NPI) | 1023075637 |
| PAC ID by PECOS | 6608068234 |
| Professional Enrollment ID | I20101014000191 |
| Full Name | Robert D Wallace |
| Organization Legal Name | UT MEDICAL GROUP, INC. |
| Address |
1505 N 2nd St Memphis TN 38107-1003 |
| Phone Number | 9017910600 |
| Gender | M |
| Medical School | JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY |
| Graduation Year | 1984 |
| Primary Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| Group Practice PAC ID | 3173435369 |
| Number of Group Practice Members | 103 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1505 N 2nd St, Memphis, TN 38107-1003 | 9017910600 | UT MEDICAL GROUP, INC. |
| 6019 Walnut Grove Rd, Memphis, TN 38120-2113 | 9018668801 | UT MEDICAL GROUP, INC. |
| Organization Legal Name | UT MEDICAL GROUP, INC. |
| Physicians | 125 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anita Waid | Nurse Practitioner | Ut Medical Group, Inc. | 910 Madison Ave, Suite 922, Memphis, TN 38103-3483 |
| Marthinus Theunis Zeeman | Addiction Medicine | Ut Medical Group, Inc. | 6401 Poplar Ave, Memphis, TN 38119-4823 |
| Charlie Busby | Family Medicine | Ut Medical Group, Inc. | 1999 Hwy 51 S, Covington, TN 38019-3630 |
| Ryan S Rahman | Family Medicine | Ut Medical Group, Inc. | 1301 Primacy Pkwy, Memphis, TN 38119-0213 |
| Jonathan William Brugger | Ophthalmology | Ut Medical Group, Inc. | 8001 Centerview Pkwy, Suite 101, Cordova, TN 38018-4260 |
| Brian T Fowler | Ophthalmology | Ut Medical Group, Inc. | 930 Madison Ave, Suite 200, Memphis, TN 38103-3410 |
| Neal Beckford | Otolaryngology | Ut Medical Group, Inc. | 7675 Wolf River Cir, Suite 202, Memphis, TN 38138-1747 |
| Robert B Canada | Internal Medicine | Ut Medical Group, Inc. | 853 Jefferson Ave, Suite 201, Memphis, TN 38103-2807 |
| Iverson C Bell Jr. | Psychiatry | Ut Medical Group, Inc. | 920 Madison Ave, Suite 200, Memphis, TN 38103-3434 |
| William L Hickerson | Plastic and Reconstructive Surgery | Ut Medical Group, Inc. | 853 Jefferson Ave, Suite 201, Memphis, TN 38103-2807 |
| Street Address |
1505 N 2ND ST |
| City | MEMPHIS |
| State | TN |
| Zip | 38107-1003 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carolyn Owens Woods | Internal Medicine | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Corey Robinson | Physician Assistant | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Joel C Kahane | Qualified Speech Language Pathologist | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Carolyn S Moore | Nurse Practitioner | Truhealth Inc | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Hemanth Veluswamy | Family Medicine | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Sandeep Kumar Rajan | Hematology/oncology | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Anna Chollet | Family Medicine | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Muneeza Khan | Family Medicine | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| John B Woods | Internal Medicine | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Gary H Lipscomb | Obstetrics/gynecology | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel D Sumrok | Family Practice | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Mohamad El-abiad | Pediatric Medicine | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Leigh Darryl Quarles | Nephrology | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Shekinah Andrews | Nurse Practitioner | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Anne W Alexandrov | Nurse Practitioner | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Mimily Harsono | Pediatric Medicine | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Steve J Schwab | Nephrology | Ut Medical Group, Inc. | 1505 N 2nd St, Memphis, TN 38107-1003 |
| Bharathi Rangaswami | Family Medicine | Ut Regional One Physicians Inc | 1064 Breedlove St, Memphis, TN 38107-2805 |
| Kafila Jaipuri | Nurse Practitioner | Ut Regional One Physicians Inc | 1064 Breedlove St, Memphis, TN 38107-2805 |
| Ramika L Jones | Nurse Practitioner | Ut Regional One Physicians Inc | 1064 Breedlove St, Memphis, TN 38107-2805 |
| Find all physicians in zip 38107 | |||
| City | MEMPHIS |
| Zip Code | 38107 |
| Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| City + Specialty | MEMPHIS + PLASTIC AND RECONSTRUCTIVE SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.