Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ato Wallace, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1417537002

Ato Wallace, MD is a Student in an Organized Health Care Education/Training Program in Lexington, Kentucky. Licensed in Kentucky. Registered with an NPI since 2021.

Licensed in
KY
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

800 Rose St
Lexington, KY 40536-7001
Phone: (859) 232-6162
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (KY)

Record details

NPI number1417537002
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 9, 2021
Last updated in NPPESApril 9, 2021
Certification dateApril 9, 2021
Mailing address800 Rose St, Lexington, KY 40536-7001

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