Mervin P Wallace, MD | |
1803 Miccosukee Commons Dr, Suite 202, Tallahassee, FL 32308-7403 | |
(850) 402-6205 | |
(850) 325-6017 |
Full Name | Mervin P Wallace |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 22 Years |
Location | 1803 Miccosukee Commons Dr, Tallahassee, Florida |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346269883 | NPI | - | NPPES |
276781300 | Medicaid | FL | |
CN3432 | Other | FL | GROUP MEDICARE RR |
P00964768 | Other | FL | MEDICARE RR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | ME95779 (Florida) | Primary |
207QG0300X | Family Medicine - Geriatric Medicine | ME95779 (Florida) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Kindred At Home | Tallahassee, FL | Home health agency |
Suncrest Omni | Tallahassee, FL | Home health agency |
Amedisys Home Health | Tallahassee, FL | Home health agency |
Encompass Health Home Health | Blountstown, FL | Home health agency |
Tallahassee Memorial Home Health Care | Tallahassee, FL | Home health agency |
Tallahassee Memorial Healthcare | Tallahassee, FL | Hospital |
Westminster Oaks | Tallahassee, FL | Nursing home |
Seven Hills Health & Rehabilitation Center | Tallahassee, FL | Nursing home |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Legacy Healthcare Services Inc | 2163339722 | 2654 |
Tallahassee Primary Care Associates Pa | 4789581901 | 20 |
Entity Name | Tallahassee Primary Care Associates Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972661262 PECOS PAC ID: 4789581901 Enrollment ID: O20031216000696 |
Mailing Address | Practice Location Address |
---|---|
Mervin P Wallace, MD Po Box 12427, Tallahassee, FL 32317-2427 Ph: (850) 297-0114 | Mervin P Wallace, MD 1803 Miccosukee Commons Dr, Suite 202, Tallahassee, FL 32308-7403 Ph: (850) 402-6205 |
Lucille T Saha, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1723 Mahan Center Blvd, Tallahassee, FL 32308 Phone: 850-878-5310 Fax: 850-878-4483 | |
Stewart Drew Warren, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1301 Hodges Dr, Tallahassee, FL 32308 Phone: 850-431-5741 Fax: 850-431-6403 | |
Dr. Christopher W Delisle, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 960 Learning Way, Tallahassee, FL 32306 Phone: 850-644-6230 Fax: 850-644-4251 | |
Dr. Leslie S Emhof, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1525 Killearn Center Blvd, Tallahassee, FL 32309 Phone: 850-893-6706 Fax: 850-893-2846 | |
Victoria Roy Bates, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1491 Governors Square Blvd, Tallahassee, FL 32301 Phone: 850-383-3300 Fax: 850-523-7490 | |
Holly Klopfenstein, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1301 Hodges Dr, Tallahassee, FL 32308 Phone: 850-431-5714 Fax: 850-431-6403 | |
Moritz Eduard Dehler, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2140 Centerville Pl, Tallahassee, FL 32308 Phone: 850-383-3300 Fax: 850-383-3497 |