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

Dr. Michael Robert Wallace, DPM

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1295828416

Dr. Michael Robert Wallace, DPM is a Podiatry in Valdosta, Georgia. Qualified in 1989, 37 years ago. Practices with Valdosta Foot and Ankle Clinic, PC, a 2-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
37
Licensed in
GA
In the registry since
2006
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

2800 N Oak St
Valdosta, GA 31602-1716
Phone: (229) 244-1211
Fax: (229) 244-2721
Show map & directions

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

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence 599 (GA)

Record details

NPI number1295828416
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorNo
NPI enumeratedOctober 2, 2006
Last updated in NPPESSeptember 18, 2013

Medicare enrollment

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

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Group practice Valdosta Foot And Ankle Clinic, P.C. — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Valdosta