Lisa D Fairchild, MD in Vicksburg, MS

Lisa D Fairchild, MD is a medicare enrolled "Pediatrics" physician in Vicksburg, Mississippi. Her current practice location is 2100 Highway 61 N, Vicksburg, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 883-5000.

Lisa D Fairchild is licensed to practice in Mississippi (license number 16733) 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 1033154794.

Contact Information

	Lisa D Fairchild, MD
	2100 Highway 61 N, Vicksburg, MS 39183-8211
	(601) 883-5000
	Not Available

Map and Direction

Physician's Profile

Full Name	Lisa D Fairchild
Gender	Female
Speciality	Pediatrics
Location	2100 Highway 61 N, Vicksburg, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033154794
Provider Enumeration Date: 06/18/2006
Last Update Date: 09/10/2020

Medicare PECOS Information:

PECOS PAC ID: 7618000407
Enrollment ID: I20100730000254

Medical Identifiers

Medical identifiers for Lisa D Fairchild such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033154794	NPI	-	NPPES
1484041	Medicaid	LA
00123219	Medicaid	MS
7004163	Other	MS	AETNA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	16733 (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. Lisa D Fairchild allows following entities to bill medicare on her behalf.

Entity Name	Vicksburg Clinic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790711158 PECOS PAC ID: 5890696330 Enrollment ID: O20040116000738

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. Lisa D Fairchild 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
Lisa D Fairchild, MD 2100 Highway 61 N, Vicksburg, MS 39183-8211 Ph: (601) 883-5000	Lisa D Fairchild, MD 2100 Highway 61 N, Vicksburg, MS 39183-8211 Ph: (601) 883-5000

Reviews and Comments

Pediatrics Doctors in Vicksburg, MS

Thomas C Moore, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1115 N Frontage Rd, Vicksburg, MS 39180 Phone: 601-634-8790
Dr. Izzeddin Kamelmaz, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-6001
Constance Phylea Barnes-woods, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-3391 Fax: 601-883-3318
Elizabeth N Roy, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-5000
Geri L Weiland, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-5000
Gordon W Sluis, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1115 N Frontage Rd, Vicksburg, MS 39180 Phone: 601-634-8790

Lisa D Fairchild, MD - Medicare Pediatrics in Vicksburg, MS