Individual provider · Type 1 NPI

Thomas Jeffrey Wallace, DO

Student in an Organized Health Care Education/Training Program · West Columbia, SC

NPI number 1730871567 Active

Practice location

145 Sunset Ct Ste 100
West Columbia, SC 29169-2429

Call (803) 739-3491 Map

Other practice locations

  • 154 Saluda Pointe Dr, Lexington, SC 29072-7295 · (803) 785-3590

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed
Family Medicine Physician 207Q00000X89976 (SC)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1730871567

Thomas Jeffrey Wallace, DO's National Provider Identifier is 1730871567, issued on May 22, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in West Columbia, SC. The record was last updated on Sep 16, 2025.