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

Individual provider Pediatrics Physician · NPI 1063419000

Carmel Wallace Jr., MD is a Pediatrics Physician in Lexington, Kentucky. Licensed in Kentucky. Registered with an NPI since 2005.

Licensed in
KY
In the registry since
2005
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

138 Leader Ave Ofc 241 University OF Kentucky Dept OF Pediatrics
Lexington, KY 40506-9983
Phone: (859) 323-1432
Fax: (859) 323-3499
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 18479 (KY)

Record details

NPI number1063419000
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 6, 2005
Last updated in NPPESDecember 18, 2015

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