Mr Lawrence Wallace, MD, PT in North Myrtle Beach, SC - Medicare Physical Therapist In Private Practice

Mr Lawrence Wallace, MD, PT is a medicare enrolled "Physical Therapist" physician in North Myrtle Beach, South Carolina. He graduated from medical school in 1997 and has 29 years of diverse experience with area of expertise as Physical Therapist In Private Practice. He is a member of the group practice Elite Hand And Upper Extremity Therapy and his current practice location is 1021 2nd Ave N Ste 6, North Myrtle Beach, South Carolina. You can reach out to his office (for appointments etc.) via phone at (843) 286-5168.

Mr Lawrence Wallace is licensed to practice in South Carolina (license number 11194) 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 1679567192.

Contact Information

	Mr Lawrence Wallace, MD, PT
	1021 2nd Ave N Ste 6, North Myrtle Beach, SC 29582-3200
	(843) 286-5168
	(844) 318-8980

Map and Direction

Physician's Profile

Full Name	Mr Lawrence Wallace
Gender	Male
Speciality	Physical Therapist In Private Practice
Experience	29 Years
Location	1021 2nd Ave N Ste 6, North Myrtle Beach, South Carolina
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:

Mr Lawrence Wallace graduated from medical school in 1997

NPI Data:

NPI Number: 1679567192
Provider Enumeration Date: 09/12/2005
Last Update Date: 01/26/2026

Medicare PECOS Information:

PECOS PAC ID: 4082678669
Enrollment ID: I20260123001478

Medical Identifiers

Medical identifiers for Mr Lawrence Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1679567192	NPI	-	NPPES
010114446	Medicaid	VA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207X00000X	Orthopaedic Surgery	MD439714 (Pennsylvania)	Secondary
225100000X	Physical Therapist	P2177 (North Carolina)	Secondary
207X00000X	Orthopaedic Surgery	0101234728 (Virginia)	Secondary
225100000X	Physical Therapist	11194 (South Carolina)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Elite Hand And Upper Extremity Therapy	3678904620	6

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. Mr Lawrence 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
Mr Lawrence Wallace, MD, PT 1021 2nd Ave N Ste 6, North Myrtle Beach, SC 29582-3200 Ph: (843) 286-5168	Mr Lawrence Wallace, MD, PT 1021 2nd Ave N Ste 6, North Myrtle Beach, SC 29582-3200 Ph: (843) 286-5168

Mr Lawrence Wallace, MD, PT - Medicare Physical Therapist In Private Practice in North Myrtle Beach, SC