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

Lewis Alfred Wallace, DO

Individual provider Internal Medicine Physician · NPI 1942292271

Lewis Alfred Wallace, DO is an Internal Medicine in Ada, Oklahoma. Graduated from Oklahoma State University College of Osteopathic Medicine in 1991, 35 years ago. Practices with Chickasaw Nation Division of Health, a 243-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
35
Trained at
Oklahoma State University College of Osteopathic Medicine
Licensed in
OK
In the registry since
2005
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1921 Stonecipher Blvd
Ada, OK 74820
Phone: (580) 421-4570
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 3060 (OK)

Record details

NPI number1942292271
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedAugust 23, 2005
Last updated in NPPESSeptember 14, 2016
Mailing address1921 Stonecipher Blvd, Ada, OK 74820

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolOKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 1991 (35 years in practice)
Group practice Chickasaw Nation Division Of Health — 243 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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