Michael T Wallace, MD in Fort Benning, GA - Medicare Emergency Medicine

Michael T Wallace, MD is a medicare enrolled "Emergency Medicine" physician in Fort Benning, Georgia. His current practice location is 6600 Van Aalst Blvd Bldg 9250, Fort Benning, Georgia. You can reach out to his office (for appointments etc.) via phone at (762) 408-2604.

Michael T Wallace is licensed to practice in Georgia (license number 12643) 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 1427624170.

Contact Information

	Michael T Wallace, MD
	6600 Van Aalst Blvd Bldg 9250, Fort Benning, GA 31905-2102
	(762) 408-2604
	Not Available

Map and Direction

Physician's Profile

Full Name	Michael T Wallace
Gender	Male
Speciality	Emergency Medicine
Location	6600 Van Aalst Blvd Bldg 9250, Fort Benning, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1427624170
Provider Enumeration Date: 06/02/2021
Last Update Date: 07/15/2025

Medicare PECOS Information:

PECOS PAC ID: 3678976271
Enrollment ID: I20210720002185

Medical Identifiers

Medical identifiers for Michael T Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1427624170	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	12643 (Georgia)	Primary

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. Michael T 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
Michael T Wallace, MD 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905-2102 Ph: (262) 506-8990	Michael T Wallace, MD 6600 Van Aalst Blvd Bldg 9250, Fort Benning, GA 31905-2102 Ph: (762) 408-2604

Reviews and Comments

Emergency Medicine Doctors in Fort Benning, GA

Eric Phillips, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 6600 Van Aalst Blvd, Fort Benning, GA 31905 Phone: 762-408-2273 Fax: 762-408-2273
Dr. Thomas Isenovski, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 7950 Martin Loop, Fort Benning, GA 31905 Phone: 706-544-3612
Dr. Michael Anthony Borsuk, DO Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 6600 Van Aalst Blvd, Fort Benning, GA 31905 Phone: 762-408-2273
Dr. Joseph Albert Aldrich Iii, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 7950 Martin Loop, Mach Department Of Emergency Medicine, Fort Benning, GA 31905 Phone: 706-544-3102
Joel Fahling, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6600 Van Aalst Blvd, Fort Benning, GA 31905 Phone: 762-408-2273
Terry Newton, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 7950 Martin Loop, Department Of Family Medicine, Fort Benning, GA 31905 Phone: 706-544-2273 Fax: 706-544-3234

Michael T Wallace, MD - Medicare Emergency Medicine in Fort Benning, GA