Charles Edward Wall Jr, MD in Starkville, MS

Charles Edward Wall Jr, MD is a medicare enrolled "Surgery" physician in Starkville, Mississippi. His current practice location is 102 Doctors Park, Starkville, Mississippi. You can reach out to his office (for appointments etc.) via phone at (662) 615-3800.

Charles Edward Wall Jr is licensed to practice in Mississippi (license number 19801) 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 1073717955.

Contact Information

	Charles Edward Wall Jr, MD
	102 Doctors Park, Starkville, MS 39759-2570
	(662) 615-3800
	(662) 615-3807

Map and Direction

Physician's Profile

Full Name	Charles Edward Wall Jr
Gender	Male
Speciality	Surgery
Location	102 Doctors Park, Starkville, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073717955
Provider Enumeration Date: 06/13/2007
Last Update Date: 10/06/2025

Medicare PECOS Information:

PECOS PAC ID: 1355434440
Enrollment ID: I20070905000756

Medical Identifiers

Medical identifiers for Charles Edward Wall Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073717955	NPI	-	NPPES
511-65666	Other	AL	BCBS
102I029294	Other	AL	MEDICARE
175531	Medicaid	AL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	19801 (Mississippi)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charles Edward Wall Jr allows following entities to bill medicare on his behalf.

Entity Name	Och Center For Breast Health
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396807814 PECOS PAC ID: 3476577545 Enrollment ID: O20060117000786

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. Charles Edward Wall Jr 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
Charles Edward Wall Jr, MD 350 N Humphreys Blvd, Memphis, TN 38120-2177 Ph: (901) 226-4003	Charles Edward Wall Jr, MD 102 Doctors Park, Starkville, MS 39759-2570 Ph: (662) 615-3800

Reviews and Comments

Surgery Doctors in Starkville, MS

Roger C Clapp Jr., M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 105 Doctors Park, Starkville, MS 39759 Phone: 662-324-1310 Fax: 662-324-7148
Dr. Daryl P Guest, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 105 Doctors Park, Starkville, MS 39759 Phone: 662-324-1310 Fax: 662-324-7148
Dr. James Travis Methvin, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 102 Doctors Park, Starkville, MS 39759 Phone: 662-615-3781 Fax: 662-615-3807
Dr. Thomas Steve Parvin, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 401 Hospital Rd., Starkville, MS 39759 Phone: 662-615-3800 Fax: 662-615-3807

Charles Edward Wall Jr, MD - Medicare Surgery in Starkville, MS