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WALLACE B MCLEOD III, INC
NPI 1194044313
Family Medicine in Oklahoma City, OK

Active since May 27, 2010CLIA 37D0470766 · Microscopy
2216 N MARTIN LUTHER KING AVE, OKLAHOMA CITY, OK 73111(405) 424-0111 Get Directions Write a Review

NPPES record last updated: October 17, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Wallace B Mcleod Iii, Inc NPPES

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

WALLACE B MCLEOD III, INC (NPI 1194044313) is a healthcare organization registered as a family medicine in Oklahoma City, Oklahoma and active in the NPI registry since May 2010. The organization holds a CLIA Microscopy certificate valid through March 30, 2027 and lists Jessie Mae Shambra, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1194044313
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameWALLACE B MCLEOD III, INC
Location Address2216 N MARTIN LUTHER KING AVEOklahoma City, OK 73111-2445
Mailing Address2216 N Martin Luther King AveOklahoma City, OK 73111-2445 · (405) 424-0111
Phone(405) 424-0111
Organization SubpartNo
Authorized OfficialJessie Mae ShambraOffice Manager · (405) 424-0111
Enumeration DateMay 27, 2010
Last NPPES UpdateOctober 17, 2022
NPPES CertifiedOctober 17, 2022
✔ NPI 1194044313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2216 N MARTIN LUTHER KING AVE, Oklahoma City, OK 73111
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Other Identifiers 1

Medicaid05538623602OK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 37D0470766

Wallace Mcleod III MD · Oklahoma City, OK
Active · expires Mar 30, 2027
CLIA Number37D0470766
Laboratory TypePhysician Office
Certificate Effective DateMarch 31, 2025
Certificate Expiration DateMarch 30, 2027
Laboratory DirectorWallace B. Mcleod
Laboratory Phone(405) 424-0111
Laboratory LocationWallace Mcleod III MD2216 Martin L King, Oklahoma City, OK 73111
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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.

DR. MICHAEL PRESTON MCLEOD D.D.S.
Dentist (General Practice)
2216 N MARTIN LUTHER KING AVE
OKLAHOMA CITY, OK 73111
Oklahoma County (405) 427-0237
WALLACE B. MCLEOD III, INC
Medical Genetics, Ph.D. Medical Genetics
2216 N MARTIN LUTHER KING AVE
OKLAHOMA CITY, OK 73111
Oklahoma County (405) 424-0111
DR. WALLACE BEVERLY MCLEOD III M.D
Family Medicine
2216 N MARTIN LUTHER KING AVE
OKLAHOMA CITY, OK 73111
Oklahoma County (405) 424-0111

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 Wallace B Mcleod III, Inc's NPI number?

The NPI number for Wallace B Mcleod III, Inc is 1194044313. It was assigned to this organization in the NPPES registry on May 27, 2010.

Where is Wallace B Mcleod III, Inc located?

Wallace B Mcleod III, Inc is located at 2216 N Martin Luther King Ave, Oklahoma City, OK 73111. The listed phone number is (405) 424-0111.

What is Wallace B Mcleod III, Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Wallace B Mcleod III, Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 37D0470766) is associated with this NPI, valid through March 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wallace B Mcleod III, Inc was last updated on October 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.