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

Kojo Wallace, MD

Individual provider Trauma Surgery Physician · NPI 1720475866

Kojo Wallace, MD is a General Surgery in Lynchburg, Virginia. Graduated from Icahn School of Medicine at Mount Sinai in 2015, 11 years ago. Practices with Centra Medical Group LLC, a 717-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
11
Trained at
Icahn School of Medicine at Mount Sinai
Licensed in
VA
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Partly verified

Some contact details are missing from the federal record.

Centra Lynchburg General Hospital 1901 Tate Springs Rd
Lynchburg, VA 24501
Phone: (434) 200-3000
Show map & directions

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

Specialties & licences

Trauma Surgery Physician (primary) Taxonomy 2086S0127X · Licence 0101285554 (VA)

Record details

NPI number1720475866
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 15, 2015
Last updated in NPPESJuly 11, 2025
Certification dateJuly 11, 2025
Mailing address909 Station Way, Huntington Station, NY 11746-1971

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Graduated 2015 (11 years in practice)
Group practice Centra Medical Group Llc — 717 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount