Jack R Pence Ii, MD is a
Urology physician based in Beavercreek, Ohio. Jack R Pence Ii is licensed to practice in Ohio (license number 35043064P) and his current practice location is 1911 N Fairfield Rd, Suite 300, Beavercreek, Ohio. He can be reached at his office (for appointments etc.) via phone at
(937) 429-7352.
NPI number for Jack R Pence Ii is 1851399414 and his current mailing address is 6680 Poe Ave, Suite 200, Dayton, Ohio. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1851399414.
Physician's Profile
| Full Name | Jack R Pence Ii |
|---|
| Gender | Male |
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| Speciality | Urology |
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| Location | 1911 N Fairfield Rd, Beavercreek, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1851399414
- Provider Enumeration Date: 07/08/2005
- Last Update Date: 03/17/2014
Medical Identifiers
Medical identifiers for Jack R Pence Ii such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1851399414 | NPI | - | NPPES |
| 0622857 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208800000X | Urology | 35-043064 (Ohio) | Secondary |
| 208800000X | Urology | 35043064 (Ohio) | Secondary |
| 208800000X | Urology | 35043064P (Ohio) | 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. Jack R Pence Ii is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jack R Pence Ii, MD
6680 Poe Ave, Suite 200,
Dayton, OH 45414-2854
Ph: (937) 280-8366 | Jack R Pence Ii, MD
1911 N Fairfield Rd, Suite 300,
Beavercreek, OH 45432-2762
Ph: (937) 429-7352 |
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