Dr Lijah Vann Gardner, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Wright Patterson Afb, Ohio. His current practice location is
4881 Sugar Maple Dr, Wright Patterson Afb, Ohio. You can reach out to his office (for appointments etc.) via phone at
(937) 257-9655.
Dr Lijah Vann Gardner is licensed to practice in California (license number 20A22029) 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 1437807039.
Physician's Profile
Full Name | Dr Lijah Vann Gardner |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 4881 Sugar Maple Dr, Wright Patterson Afb, Ohio |
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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: 1437807039
- Provider Enumeration Date: 03/13/2022
- Last Update Date: 08/14/2024
Medicare PECOS Information:
- PECOS PAC ID: 9830570407
- Enrollment ID: I20220714001246
Medical Identifiers
Medical identifiers for Dr Lijah Vann Gardner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1437807039 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 20A22092 (California) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | 20A22029 (California) | 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 Lijah Vann Gardner 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 Lijah Vann Gardner, DO 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 Ph: () - | Dr Lijah Vann Gardner, DO 4881 Sugar Maple Dr, Wright Patterson Afb, OH 45433-5529 Ph: (937) 257-9655 |
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