Dr Odilichi Ezenwanne, MD is a medicare enrolled "Preventive Medicine - Public Health & General Preventive Medicine" physician in Tunica, Mississippi. He graduated from medical school in 2001 and has 23 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Aaron E Henry Community Health and his current practice location is
1820 Peabody St, Tunica, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(662) 363-3656.
Dr Odilichi Ezenwanne is licensed to practice in Wisconsin (license number 67275) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1841504206.
Physician's Profile
| Full Name | Dr Odilichi Ezenwanne |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 23 Years |
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| Location | 1820 Peabody St, Tunica, Mississippi |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Odilichi Ezenwanne graduated from medical school in 2001
NPI Data:
- NPI Number: 1841504206
- Provider Enumeration Date: 07/27/2010
- Last Update Date: 02/18/2020
Medicare PECOS Information:
- PECOS PAC ID: 6406127265
- Enrollment ID: I20191220001793
Medical Identifiers
Medical identifiers for Dr Odilichi Ezenwanne such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1841504206 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2083P0901X | Preventive Medicine - Public Health & General Preventive Medicine | 27125 (Mississippi) | Secondary |
| 2083P0901X | Preventive Medicine - Public Health & General Preventive Medicine | 67275 (Wisconsin) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Aaron E Henry Community Health | 1153230560 | 9 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Odilichi Ezenwanne allows following entities to bill medicare on his behalf.
| Entity Name | Aaron E Henry Community Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003814104
PECOS PAC ID: 1153230560
Enrollment ID: O20040330001267 |
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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 Odilichi Ezenwanne 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 |
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Dr Odilichi Ezenwanne, MD
1820 Peabody St,
Tunica, MS 38676-9441
Ph: (662) 363-3656 | Dr Odilichi Ezenwanne, MD
1820 Peabody St,
Tunica, MS 38676-9441
Ph: (662) 363-3656 |
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