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

Individual provider Family Medicine Physician · NPI 1265475206

Tracey C Wallace, MD is a Family Practice in Atlanta, Georgia. Graduated from Loma Linda University School of Medicine in 1993, 33 years ago. Practices with Northside Urgent Care Holding LLC, a 80-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
33
Trained at
Loma Linda University School of Medicine
Licensed in
GA
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

3525 Piedmont Rd NE Bldg 7-601
Atlanta, GA 30305-1578
Phone: (770) 509-1025
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 042483 (GA)

Record details

NPI number1265475206
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 14, 2006
Last updated in NPPESFebruary 26, 2021
Certification dateFebruary 26, 2021
Mailing address1121 Johnson Ferry Rd, Suite 100, Marietta, GA 30068-5425

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated 1993 (33 years in practice)
Group practice Northside Urgent Care Holding Llc — 80 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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