JOHN M. WALLACE (M.D.) – Pulmonary Disease Physician, NPI 1174537708
Preparing for Medicare enrollment?
Use our CMS-855 prep checklist: which form applies (855I, 855O, or 855A), readiness score, NPPES field map, and Section 12 documents. Reassignment uses CMS-855I Section 4F—not the discontinued CMS-855R form.
Open Medicare 855 Prep tool →Pulmonary Disease Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for JOHN M. WALLACE (M.D.)
1203, Jefferson Street, Laurel, Jones County, Mississippi, 39440, United States
LAUREL, MS 394404354
Phone: (601) 649-2863
Fax: (601) 649-9479
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $50.
Total Amount is formed as General ($50) + Research ($0) + Ownership ($0) = $50.
Last reported payment date: 2023-04-19 • Largest payer in this snapshot: Collegium Pharmaceutical, Inc. ($50).
Total Amount
$50
General + Research + Ownership
Payments
3
Total payment records
General Amount
$50
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Collegium Pharmaceutical, Inc. | $50 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 39440)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | MS | |
| Family Practice | KY | |
| - | MS | |
| - | MS | |
| - | MS | |
| - | MS | |
| Family Practice | MS | |
| - | MS | |
| - | MS | |
| - | MS |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.