Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Wallace Lock, MD

Individual provider Emergency Medicine Physician · NPI 1437545761

Wallace Lock, MD practises Emergency Medicine in Fort Smith, Arkansas. Graduated from University of Arkansas College of Medicine in 2015, 11 years ago. Practices with Southeastern Emergency Physicians LLC, a 786-clinician group and accepts Medicare assignment. Licensed in Arkansas and Tennessee.

Years since qualifying
11
Trained at
University of Arkansas College of Medicine
Licensed in
AR, TN
In the registry since
2015
Specialties on file
3
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

612 S 12th St
Fort Smith, AR 72901-4702
Phone: (479) 424-3193
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 67669 (TN)
Emergency Medicine Physician Taxonomy 207P00000X · Licence E-10064 (AR)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1437545761
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 14, 2015
Last updated in NPPESApril 4, 2024
Certification dateApril 4, 2024

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolUNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Southeastern Emergency Physicians Llc — 786 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients311
Services billed 517 a service is one billed item, such as a visit, a test or a procedure
Average patient age70

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Southeastern Emergency Physicians LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 786 clinicians in the practice; 12 are shown here.

Other providers in Fort Smith