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

Mikaila Wallace, DO

Individual provider Family Medicine Physician · NPI 1023687217

Mikaila Wallace, DO is a Family Practice in Maryville, Missouri. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2024, 2 years ago. Practices with Mosaic Medical Center - Maryville, a 77-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri and Nebraska.

Years since qualifying
2
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
MO, NE
In the registry since
2021
Specialties on file
2
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.

See every abbreviation used in this directory →

Practice location Address checks out

2016 S Main St
Maryville, MO 64468-2655
Phone: (660) 562-2525
Fax: (660) 562-7996
Show map & directions

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

Additional practice locations (1)

  • 4600 Valley Rd Ste 200, Lincoln, NE 68510-4882 — (402) 327-6921

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 2024030678 (MO)
Family Medicine Physician Taxonomy 207Q00000X · Licence TEP9082 (NE)

Record details

NPI number1023687217
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 22, 2021
Last updated in NPPESMay 12, 2025
Certification dateMay 12, 2025
Mailing address2016 S Main St, Maryville, MO 64468-2655

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2024 (2 years in practice)
Group practice Mosaic Medical Center - Maryville — 77 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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