William David Wallace, MD in Jackson, MS

William David Wallace, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Jackson, Mississippi. His current practice location is 969 Lakeland Dr, Jackson, Mississippi. You can reach out to his office (for appointments etc.) via phone at (601) 200-2000.

William David Wallace is licensed to practice in Mississippi (license number 28885) 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 1679060438.

Contact Information

	William David Wallace, MD
	969 Lakeland Dr, Jackson, MS 39216-4606
	(601) 200-2000
	Not Available

Map and Direction

Physician's Profile

Full Name	William David Wallace
Gender	Male
Speciality	Radiology - Diagnostic Radiology
Location	969 Lakeland Dr, Jackson, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1679060438
Provider Enumeration Date: 04/17/2018
Last Update Date: 07/12/2024

Medicare PECOS Information:

PECOS PAC ID: 0749568707
Enrollment ID: I20230807002752

Medical Identifiers

Medical identifiers for William David Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1679060438	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0202X	Radiology - Diagnostic Radiology	28885 (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. William David Wallace allows following entities to bill medicare on his behalf.

Entity Name	Lakeland Radiologists Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1861428351 PECOS PAC ID: 4183683089 Enrollment ID: O20041006001125

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. William David 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
William David Wallace, MD Po Box 23073, Jackson, MS 39225-3073 Ph: (601) 200-6162	William David Wallace, MD 969 Lakeland Dr, Jackson, MS 39216-4606 Ph: (601) 200-2000

Reviews and Comments

Radiology Doctors in Jackson, MS

Dr. Christophor D Reed, DO Radiology Medicare: Accepting Medicare Assignments Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-815-5615
Dr. Patrick James Robbins, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-984-5600 Fax: 601-984-5608
Dr. Richard B Friedman, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1225 N State St, Jackson, MS 39202 Phone: 601-968-1416 Fax: 601-968-1218
Teddi Leigh Berry, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2500 N State St, Department Of Radiology, Jackson, MS 39216 Phone: 601-984-2695 Fax: 601-984-2683
Katherine Leigh Ragland, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2500 N State St, Dept. Of Radiology, Jackson, MS 39216 Phone: 601-984-2538
Wayne Fai Chan, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1500 E Woodrow Wilson Ave, Radiation Therapy, Jackson, MS 39216 Phone: 601-362-4471 Fax: 601-364-1588
Dr. Mary Oneal, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1500 E Woodrow Wilson Ave, Jackson, MS 39216 Phone: 601-362-4471

William David Wallace, MD - Medicare Radiology in Jackson, MS