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

Dr. Bradley A Wallace, MD

Individual provider Neurological Surgery Physician · NPI 1134160161

Dr. Bradley A Wallace, MD is a Neurosurgery in Jacksonville, Florida. Graduated from University of Arkansas College of Medicine in 1998, 28 years ago. Practices with Lyerly Baptist Inc, a 70-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
28
Trained at
University of Arkansas College of Medicine
Licensed in
FL
In the registry since
2006
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

836 Prudential Dr Ste 1400
Jacksonville, FL 32207-8340
Phone: (904) 388-6518
Fax: (904) 384-1005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1747 Baptist Clay Dr Ste 200, Fleming Island, FL 32003-8505 — (904) 202-6683
  • 1370 13th Ave S Ste 118, Jacksonville Beach, FL 32250-3206 — (904) 388-6518

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence ME91779 (FL)

Record details

NPI number1134160161
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 9, 2006
Last updated in NPPESJune 17, 2026
Certification dateJune 17, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEUROSURGERY
Medical schoolUNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduated 1998 (28 years in practice)
Group practice Lyerly Baptist Inc — 70 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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