Dr Daniel John Wattendorf, MD is a medicare enrolled "Medical Genetics - Clinical Genetics (m.d.)" physician in Keesler Afb, Mississippi. His current practice location is
301 Fisher St, Rm 1a132, Keesler Afb, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(228) 377-6393.
Dr Daniel John Wattendorf is licensed to practice in Pennsylvania (license number MD067656L) 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 1760496178.
Physician's Profile
| Full Name | Dr Daniel John Wattendorf |
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| Gender | Male |
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| Speciality | Medical Genetics - Clinical Genetics (m.d.) |
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| Location | 301 Fisher St, Keesler Afb, Mississippi |
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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: 1760496178
- Provider Enumeration Date: 07/28/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 8628296977
- Enrollment ID: I20140827002322
Medical Identifiers
Medical identifiers for Dr Daniel John Wattendorf such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1760496178 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | MD067656L (Pennsylvania) | Primary |
| 207SC0300X | Medical Genetics - Clinical Cytogenetics | MD067656L (Pennsylvania) | Primary |
| 207SG0201X | Medical Genetics - Clinical Genetics (m.d.) | MD067656L (Pennsylvania) | 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. Dr Daniel John Wattendorf 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 |
|---|
Dr Daniel John Wattendorf, MD
301 Fisher St, Rm 1a132,
Keesler Afb, MS 39534-2159
Ph: (228) 377-6393 | Dr Daniel John Wattendorf, MD
301 Fisher St, Rm 1a132,
Keesler Afb, MS 39534-2159
Ph: (228) 377-6393 |
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