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

Dr. Michael Robert Wallace, DPM

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1295828416

Dr. Michael Robert Wallace, DPM is a Podiatry in Valdosta, Georgia. Qualified in 1989, 37 years ago. Practices with Valdosta Foot and Ankle Clinic, PC, a 2-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
37
Licensed in
GA
In the registry since
2006
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

2800 N Oak St
Valdosta, GA 31602-1716
Phone: (229) 244-1211
Fax: (229) 244-2721
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence 599 (GA)

Record details

NPI number1295828416
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorNo
NPI enumeratedOctober 2, 2006
Last updated in NPPESSeptember 18, 2013
Mailing address2800 N Oak St, Valdosta, GA 31602-1716

Medicare enrollment

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

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Group practice Valdosta Foot And Ankle Clinic, P.C. — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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