Jerry Michael Mccormick, MD is a
Dermatology physician based in Brooklyn Center, Minnesota. Jerry Michael Mccormick is licensed to practice in Minnesota (license number 29706) and his current practice location is 6845 Lee Ave N, Mail Stop 31400a, Brooklyn Center, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(763) 569-0300.
NPI number for Jerry Michael Mccormick is 1811962616 and his current mailing address is 6845 Lee Ave N, 31400a, Brooklyn Center, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1811962616.
Physician's Profile
| Full Name | Jerry Michael Mccormick |
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| Gender | Male |
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| Speciality | Dermatology |
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| Location | 6845 Lee Ave N, Brooklyn Center, Minnesota |
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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: 1811962616
- Provider Enumeration Date: 02/23/2006
- Last Update Date: 08/20/2008
Medical Identifiers
Medical identifiers for Jerry Michael Mccormick such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1811962616 | NPI | - | NPPES |
| 158380800 | Medicaid | MN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | 29706 (Minnesota) | Primary |
| 207N00000X | Dermatology | 24722 (Wisconsin) | Secondary |
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. Jerry Michael Mccormick 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 |
|---|
Jerry Michael Mccormick, MD
6845 Lee Ave N, 31400a,
Brooklyn Center, MN 55429-1717
Ph: (763) 503-4395 | Jerry Michael Mccormick, MD
6845 Lee Ave N, Mail Stop 31400a,
Brooklyn Center, MN 55429-1717
Ph: (763) 569-0300 |
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