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Contact Information

KOJO WALLACE, MD
CENTRA LYNCHBURG GENERAL HOSPITAL
1901 TATE SPRINGS RD
LYNCHBURG, VA24501
 Phone: 434-200-3000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Trauma Surgery

2086S0127X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for KOJO WALLACE · (Male)

NPI Number 1720475866
Status Active
Credentials MD
Entity Individual
Enumeration date 04/15/2015
Last updated 07/11/2025 - About 11 months ago
Sole proprietor 1 Yes
Identifiers
  • VA License # 0101285554
Hospital affiliation(s)
  • NORTH SHORE UNIVERSITY HOSPITAL - (Acute Care)
    300 COMMUNITY DRIVE
    MANHASSET, NY 11030
  • SOUTHSIDE HOSPITAL - (Acute Care)
    301 EAST MAIN STREET
    BAY SHORE, NY 11706
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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