Dr R Dale Davis, MD in Green Bay, WI - Medicare Internal Medicine

Dr R Dale Davis, MD is a medicare enrolled "Internal Medicine" physician in Green Bay, Wisconsin. His current practice location is 704 S Webster Ave, Ste 102, Green Bay, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 433-7516.

Dr R Dale Davis is licensed to practice in Wisconsin (license number 30054) 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 1366455503.

Contact Information

	Dr R Dale Davis, MD
	704 S Webster Ave, Ste 102, Green Bay, WI 54301
	(920) 433-7516
	(920) 433-7464

Map and Direction

Physician's Profile

Full Name	Dr R Dale Davis
Gender	Male
Speciality	Internal Medicine
Location	704 S Webster Ave, Green Bay, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1366455503
Provider Enumeration Date: 08/15/2006
Last Update Date: 07/13/2010

Medicare PECOS Information:

PECOS PAC ID: 0547160756
Enrollment ID: I20100817000381

Medical Identifiers

Medical identifiers for Dr R Dale Davis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366455503	NPI	-	NPPES
31492900	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	30054 (Wisconsin)	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 R Dale Davis allows following entities to bill medicare on his behalf.

Entity Name	Bellin Memorial Hospital Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609838473 PECOS PAC ID: 8820900749 Enrollment ID: O20031121000089

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 R Dale Davis 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 R Dale Davis, MD 704 S Webster Ave, Ste 102, Green Bay, WI 54301 Ph: (920) 433-7516	Dr R Dale Davis, MD 704 S Webster Ave, Ste 102, Green Bay, WI 54301 Ph: (920) 433-7516

Reviews and Comments

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Dr R Dale Davis, MD - Medicare Internal Medicine in Green Bay, WI