Dr Patty K Pettway, DO is a medicare enrolled "Family Medicine" physician in Havana, Arkansas. Her current practice location is
310 West Broadway Street, Havana, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(479) 476-2827.
Dr Patty K Pettway is licensed to practice in Arkansas (license number N8252) 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 1376506881.
Physician's Profile
Full Name | Dr Patty K Pettway |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 310 West Broadway Street, Havana, Arkansas |
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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: 1376506881
- Provider Enumeration Date: 04/07/2006
- Last Update Date: 09/18/2015
Medicare PECOS Information:
- PECOS PAC ID: 5294773883
- Enrollment ID: I20180905002360
Medical Identifiers
Medical identifiers for Dr Patty K Pettway such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1376506881 | NPI | - | NPPES |
121717003 | Medicaid | AR | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | N8252 (Arkansas) | Primary |
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 Patty K Pettway allows following entities to bill medicare on her behalf.
Entity Name | Fort Smith Hma Pbc Management Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1477888907 PECOS PAC ID: 8224172127 Enrollment ID: O20100308000744 |
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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 Patty K Pettway 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 Patty K Pettway, DO Po Box 639, Danville, AR 72833-0639 Ph: (479) 495-2241 | Dr Patty K Pettway, DO 310 West Broadway Street, Havana, AR 72842-0099 Ph: (479) 476-2827 |
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