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

Individual provider Plastic and Reconstructive Surgery Physician · NPI 1023075637

Dr. Robert D Wallace, MD is a Plastic and Reconstructive Surgery in Memphis, Tennessee. Graduated from Jefferson Medical College of Thomas Jefferson University in 1984, 42 years ago. Works from 2 locations and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
42
Trained at
Jefferson Medical College of Thomas Jefferson University
Licensed in
TN
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

1068 Cresthaven Rd Ste 500
Memphis, TN 38119
Phone: (901) 866-8525
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1910 Nonconnah Blvd, Memphis, TN 38132-2113 — (901) 448-2300

Specialties & licences

Plastic and Reconstructive Surgery Physician (primary) Taxonomy 2086S0122X · Licence 27658 (TN)

Record details

NPI number1023075637
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 27, 2006
Last updated in NPPESFebruary 1, 2019
Mailing address1407 Union Ave Ste 700, Memphis, TN 38104-3641

Medicare enrollment

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

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Medical schoolJEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduated 1984 (42 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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