Mr Derek Kelly Coburn, PA is a medicare enrolled "Physician Assistant" physician in Charlotte, North Carolina. His current practice location is
2001 Vail Ave, Charlotte, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(208) 863-8974.
Mr Derek Kelly Coburn is licensed to practice in North Carolina (license number 0010-06199) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1861851784.
Physician's Profile
| Full Name | Mr Derek Kelly Coburn |
|---|
| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 2001 Vail Ave, Charlotte, North Carolina |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Derek Kelly Coburn attended and graduated from in
NPI Data:
- NPI Number: 1861851784
- Provider Enumeration Date: 02/19/2016
- Last Update Date: 06/10/2020
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Mr Derek Kelly Coburn such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861851784 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | 001006199 (North Carolina) | Secondary |
| 363A00000X | Physician Assistant | 0010-06199 (North Carolina) | 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. Mr Derek Kelly Coburn 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 |
|---|
Mr Derek Kelly Coburn, PA
3740 Wendwood Ln Apt 108,
Charlotte, NC 28211-1257
Ph: (208) 863-8974 | Mr Derek Kelly Coburn, PA
2001 Vail Ave,
Charlotte, NC 28207-1248
Ph: (208) 863-8974 |
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