Edward Kirkham Gore, MD is a medicare enrolled "Family Medicine" physician in Houston, Mississippi. His current practice location is
1002 E Madison St, Houston, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(662) 456-2037.
Edward Kirkham Gore is licensed to practice in Mississippi (license number 04981) 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 1205802584.
Physician's Profile
Full Name | Edward Kirkham Gore |
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Gender | Male |
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Speciality | Family Medicine |
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Location | 1002 E Madison St, Houston, Mississippi |
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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: 1205802584
- Provider Enumeration Date: 02/27/2006
- Last Update Date: 06/20/2018
Medicare PECOS Information:
- PECOS PAC ID: 0941469019
- Enrollment ID: I20120308000549
Medical Identifiers
Medical identifiers for Edward Kirkham Gore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1205802584 | NPI | - | NPPES |
1194833400 | Other | MS | GROUP NPI |
00112415 | Medicaid | MS | |
07978511 | Medicaid | MS | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 04981 (Mississippi) | 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. Edward Kirkham Gore allows following entities to bill medicare on his behalf.
Entity Name | Southern Health Corp Of Houston, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1942484365 PECOS PAC ID: 0042102352 Enrollment ID: O20040422000717 |
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Entity Name | Woodland Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1629282330 PECOS PAC ID: 9436346053 Enrollment ID: O20110428000315 |
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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. Edward Kirkham Gore 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 |
Edward Kirkham Gore, MD Po Box 432, Houston, MS 38851-0432 Ph: (662) 456-2037 | Edward Kirkham Gore, MD 1002 E Madison St, Houston, MS 38851-2417 Ph: (662) 456-2037 |
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