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DR. WILLIAM ARTHUR WALLACE JR. M.D.
NPI 1184842627
Surgery - Plastic and Reconstructive Surgery in Fleming Island, FL

Active since April 22, 2007PECOS Enrolled
1679 EAGLE HARBOR PKWY, SUITE C, FLEMING ISLAND, FL 32003(904) 348-0727(904) 621-9272 Get Directions Write a Review

NPPES record last updated: November 1, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. William Arthur Wallace Jr. M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WILLIAM ARTHUR WALLACE JR. M.D. (NPI 1184842627) is an individual plastic and reconstructive surgery provider in Fleming Island, Florida, licensed in Florida (ME107749) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184842627
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameDR. WILLIAM ARTHUR WALLACE JR.Credential: M.D.
Location Address1679 EAGLE HARBOR PKWY, SUITE CFleming Island, FL 32003-4815
Mailing Address1679 Eagle Harbor Pkwy, Suite CFleming Island, FL 32003-4815 · (904) 348-0727 · Fax (904) 621-9272
Phone(904) 348-0727
Fax(904) 621-9272
Sole ProprietorNo
Enumeration DateApril 22, 2007
Last NPPES UpdateNovember 1, 2015
✔ NPI 1184842627 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
Licenses✔ Licensed in FL · ME107749✔ Licensed in OH · 35.079632
Definition
A surgeon who specializes in plastic and reconstructive surgery.
1679 EAGLE HARBOR PKWY, Fleming Island, FL 32003
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. William Arthur Wallace Jr. M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walker, folding, wheeled, adjustable or fixed height E0143
DME-Other DME · category DE000N
1 supplier23 claims23 services$46.16 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MY SIDE MEDICINE LLC
Family Medicine
1679 EAGLE HARBOR PKWY
FLEMING ISLAND, FL 32003
Duval County (904) 289-1850
JACKSONVILLE MULTISPECIALTY SERVICES, LLC
Orthopaedic Surgery
1679 EAGLE HARBOR PKWY, SUITE B
ORANGE PARK, FL 32003
Duval County (904) 399-6109
FLEMING ISLAND PLASTIC SURGERY LLC
Plastic Surgery
1679 EAGLE HARBOR PKWY, SUITE C
FLEMING ISLAND, FL 32003
Duval County (904) 348-0727

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is William Wallace's NPI number?

The NPI number for William Wallace is 1184842627. It was assigned to this individual provider in the NPPES registry on April 22, 2007.

Where is William Wallace located?

William Wallace practices at 1679 Eagle Harbor Pkwy Suite C, Fleming Island, FL 32003. The listed phone number is (904) 348-0727.

What is William Wallace's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is William Wallace enrolled in Medicare?

Yes. William Wallace is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for William Wallace was last updated on November 1, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.