Randy S Hathorn, DMD is a medicare enrolled "Dentist - General Practice" provider in Bassfield, Mississippi. His current practice location is
218 A Gen Robert E Blount Dr, Bassfield, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(601) 943-5426.
Randy S Hathorn is licensed to practice in Mississippi (license number 2016 83) 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 1912018748.
Healthcare Provider's Profile
Full Name | Randy S Hathorn |
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Gender | Male |
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Speciality | Dentist - General Practice |
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Location | 218 A Gen Robert E Blount Dr, Bassfield, Mississippi |
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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: 1912018748
- Provider Enumeration Date: 08/31/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 1052616315
- Enrollment ID: I20160224001030
Medical Identifiers
Medical identifiers for Randy S Hathorn such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1912018748 | NPI | - | NPPES |
00060050 | Medicaid | MS | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 2016 83 (Mississippi) | 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. Randy S Hathorn 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 |
Randy S Hathorn, DMD Po Box 549, Bassfield, MS 39421-0549 Ph: (601) 943-5126 | Randy S Hathorn, DMD 218 A Gen Robert E Blount Dr, Bassfield, MS 39421-0549 Ph: (601) 943-5426 |
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