KACEY L WALLACE (DO) – Family Medicine Physician, NPI 1306868534

Family Medicine Physician

KACEY L WALLACE (DO) is a healthcare provider. based in Chickasha, Oklahoma. specializing in Family Medicine Physician. They hold the professional credentials DO. They hold a License No. 4339 (OK). The NPI Number for KACEY L WALLACE (DO) is 1306868534

Main info

Female

22 Years Of Experience

Accepts Medicare Assignment

Name

KACEY L WALLACE (DO)

NPI

1306868534

Phone

(405) 544-2940

Address

1000 W CHOCTAW AVE STE 9

Enumeration Date

24 July 2006

Last Update Date

24 November 2023

Doctor Profile

Medical School Name

OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE

Secondary Phone

4057561414

Graduation Year

2004 (22 years ago)

PAC ID

7517974041

Group Practice PAC ID

9032200084

Professional Enrollment ID

I20060309000351

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience62

Completeness75

Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for KACEY L WALLACE (DO)

1000 W CHOCTAW AVE STE 9
CHICKASHA, OK 73018
Phone: (405) 544-2940
Fax: (405) 337-9632
Type: Mailing
217, South Main Street, Lindsay, Garvin County, Oklahoma, 73052, United States
LINDSAY, OK 730525633
Phone: (405) 756-1414
Fax: (405) 756-1162
Type: Mailing
2222, West Iowa Avenue, Chickasha, Grady County, Oklahoma, 73018, United States
CHICKASHA, OK 730182738
Phone: (405) 756-1414
Fax: (405) 756-1162
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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 73018)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 9032200084View full group profile

Name	Specialty	State
CHRISTINE PACHECO (LCSW)	Clinical Social Worker	OK
MALORI LAWRENCE (APRN)	Nurse Practitioner	OK
DR. MITSI A FAUBION (DO)	Family Practice	OK
SEAN KELLY BAKER (CNP)	Nurse Practitioner	OK
MRS. ELIZABETH CLOWERS (NP-C)	Nurse Practitioner	CO
JAMES RICHARD LYNCH (APRN)	Nurse Practitioner	OK
MISS MACY BOWEN (APRN)	Nurse Practitioner	OK
MRS. SARAH ELIZABETH BUSACCO (APRN-CNP)	Nurse Practitioner	OK
NOVYCE V FERGUSON (APRN)	-	OK
ROSS LANE FISHER (MD)	Internal Medicine	OK