John Gray Wallace, MD in Kosciusko, MS - Medicare Family Practice

John Gray Wallace, MD is a medicare enrolled "Family Medicine" physician in Kosciusko, Mississippi. He went to University Of Mississippi School Of Medicine and graduated in 2011 and has 13 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Premier Medical Group Of Mississippi Llc and his current practice location is 332 Highway 12 W, Kosciusko, Mississippi. You can reach out to his office (for appointments etc.) via phone at (662) 289-1800.

John Gray Wallace is licensed to practice in Mississippi (license number 22522) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1831486596.

Contact Information

	John Gray Wallace, MD
	332 Highway 12 W, Kosciusko, MS 39090-3209
	(662) 289-1800
	(662) 289-2486

Map and Direction

Physician's Profile

Full Name	John Gray Wallace
Gender	Male
Speciality	Family Practice
Experience	13 Years
Location	332 Highway 12 W, Kosciusko, Mississippi
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

John Gray Wallace attended and graduated from University Of Mississippi School Of Medicine in 2011

NPI Data:

NPI Number: 1831486596
Provider Enumeration Date: 07/01/2011
Last Update Date: 09/22/2014

Medicare PECOS Information:

PECOS PAC ID: 3072756808
Enrollment ID: I20130827000525

Medical Identifiers

Medical identifiers for John Gray Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1831486596	NPI	-	NPPES
07830815	Medicaid	MS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	22522 (Mississippi)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Sta Home Health And Hospice	Carthage, MS	Home health agency
Mississippi Homecare Of Eupora	Eupora, MS	Home health agency
Sta Home Hospice Of Mississippi	Jackson, MS	Hospice
Baptist Medical Center Attala	Kosciusko, MS	Hospital
Attala County Nursing Center	Kosciusko, MS	Nursing home

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Premier Medical Group Of Mississippi Llc	8729973623	27

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. John Gray Wallace allows following entities to bill medicare on his behalf.

Entity Name	Premier Medical Group Of Mississippi Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790827038 PECOS PAC ID: 8729973623 Enrollment ID: O20040219000254

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. John Gray Wallace 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
John Gray Wallace, MD Po Box 23996, Jackson, MS 39225-3996 Ph: (601) 206-6100	John Gray Wallace, MD 332 Highway 12 W, Kosciusko, MS 39090-3209 Ph: (662) 289-1800

Reviews and Comments

Family Medicine Doctors in Kosciusko, MS

Dr. Timothy J Alford, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 332 Highway 12 W, Kosciusko, MS 39090 Phone: 662-289-1800 Fax: 662-289-2486
Dr. Michael G Holman, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 332 Highway 12 W, Kosciusko, MS 39090 Phone: 662-289-1800 Fax: 662-289-2486
Robert Gregory Browning, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 530 Veterans Memorial Dr, Kosciusko, MS 39090 Phone: 662-289-9155 Fax: 662-289-7752
Dr. Edward E Bryant, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 530 Veterans Memorial Dr, Kosciusko, MS 39090 Phone: 662-289-9155 Fax: 662-289-7752
Dr. Jackey D Turner, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 332 Highway 12 W, Kosciusko, MS 39090 Phone: 662-289-1800 Fax: 662-289-2486
Dr. Richard C Carter, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 332 Highway 12 W, Kosciusko, MS 39090 Phone: 662-289-1800 Fax: 662-289-2486
Dr. James J Withers, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 332 Highway 12 W, Kosciusko, MS 39090 Phone: 662-289-1800 Fax: 662-289-2486

John Gray Wallace, MD - Medicare Family Practice in Kosciusko, MS