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

Individual provider Orthopaedic Surgery Physician · NPI 1972558542

Dr. Wallace W Weatherly, MD is an Orthopedic Surgery in Jackson, Mississippi. Graduated from University of Mississippi School of Medicine in 1987, 39 years ago. Practices with Discovery Medical Network Sweetwater LLC, a 7-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
39
Trained at
University of Mississippi School of Medicine
Licensed in
MS
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

1801 Crane Ridge Dr Ste C
Jackson, MS 39216-4902
Phone: (601) 981-5633
Fax: (601) 981-1844
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence 11796 (MS)

Record details

NPI number1972558542
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 23, 2006
Last updated in NPPESDecember 19, 2017

Medicare enrollment

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

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolUNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated 1987 (39 years in practice)
Group practice Discovery Medical Network Sweetwater Llc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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