Dr Jan H Petri, MD is a medicare enrolled "Otolaryngology" physician in Collierville, Tennessee. Her current practice location is
2028 W Poplar Ave Ste 112, Collierville, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(901) 861-2526.
Dr Jan H Petri is licensed to practice in Tennessee (license number 17612) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1033175682.
Physician's Profile
| Full Name | Dr Jan H Petri |
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| Gender | Female |
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| Speciality | Otolaryngology |
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| Location | 2028 W Poplar Ave Ste 112, Collierville, Tennessee |
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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: 1033175682
- Provider Enumeration Date: 04/24/2006
- Last Update Date: 07/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 4981764305
- Enrollment ID: I20081114000656
Medical Identifiers
Medical identifiers for Dr Jan H Petri such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1033175682 | NPI | - | NPPES |
| 3073227 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Y00000X | Otolaryngology | 17612 (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. Dr Jan H Petri 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 Jan H Petri, MD
9554 Fox Hill Cir S,
Germantown, TN 38139-6829
Ph: (901) 861-2526 | Dr Jan H Petri, MD
2028 W Poplar Ave Ste 112,
Collierville, TN 38017-0618
Ph: (901) 861-2526 |
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