Connor Wakefield, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Fort Sam Houston, Texas. His current practice location is
3551 Roger Brooke Dr, Fort Sam Houston, Texas. You can reach out to his office (for appointments etc.) via phone at
(210) 464-8465.
Connor Wakefield is licensed to practice in Virginia (license number 0101276689) 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 1447814850.
Physician's Profile
| Full Name | Connor Wakefield |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 3551 Roger Brooke Dr, Fort Sam Houston, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1447814850
- Provider Enumeration Date: 05/01/2019
- Last Update Date: 04/20/2024
Medicare PECOS Information:
- PECOS PAC ID: 8325417801
- Enrollment ID: I20221205001732
Medical Identifiers
Medical identifiers for Connor Wakefield such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1447814850 | NPI | - | NPPES |
| 1447814850 | Medicaid | IL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | 0101276689 (Virginia) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | 0101276689 (Virginia) | 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. Connor Wakefield 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 |
|---|
Connor Wakefield,
4700 Las Vegas Blvd N,
Nellis Afb, NV 89191-6600
Ph: (702) 653-2273 | Connor Wakefield,
3551 Roger Brooke Dr,
Fort Sam Houston, TX 78234-4504
Ph: (210) 464-8465 |
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