Mr Albert Fitz Gruber Ii, DMD is a medicare enrolled "Dentist - General Practice" provider in Memphis, Illinois. His current practice location is
University Of Tennessee College Of Dentistry, 875 Union Ave, Memphis, Illinois. You can reach out to his office (for appointments etc.) via phone at
(901) 448-6271.
Mr Albert Fitz Gruber Ii is licensed to practice in Tennessee (license number 11979) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1386714210.
Healthcare Provider's Profile
Full Name | Mr Albert Fitz Gruber Ii |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | University Of Tennessee College Of Dentistry, Memphis, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1386714210
- Provider Enumeration Date: 11/08/2006
- Last Update Date: 10/24/2024
Medicare PECOS Information:
- PECOS PAC ID: 7113226200
- Enrollment ID: I20160425000072
Medical Identifiers
Medical identifiers for Mr Albert Fitz Gruber Ii such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1386714210 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 019-019995 (Illinois) | Secondary |
1223G0001X | Dentist - General Practice | 12009737A (Indiana) | Secondary |
1223G0001X | Dentist - General Practice | 6830 (Louisiana) | Secondary |
1223G0001X | Dentist - General Practice | 11979 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Albert Fitz Gruber Ii is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Albert Fitz Gruber Ii, DMD 1697 Lisson Lane, Collierville, TN 38017 Ph: (708) 212-7995 | Mr Albert Fitz Gruber Ii, DMD University Of Tennessee College Of Dentistry, 875 Union Ave, Memphis, IL 38163 Ph: (901) 448-6271 |
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