Mr William Phillip Fortenberry Jr, in Petal, MS

Mr William Phillip Fortenberry Jr, is a medicare enrolled "Family Medicine" physician in Petal, Mississippi. His current practice location is 50 Parkway Ln, Petal, Mississippi. You can reach out to his office (for appointments etc.) via phone at (601) 544-7404.

Mr William Phillip Fortenberry Jr is licensed to practice in Mississippi (license number 28846) 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 1235521923.

Contact Information

	Mr William Phillip Fortenberry Jr,
	50 Parkway Ln, Petal, MS 39465-3035
	(601) 544-7404
	Not Available

Map and Direction

Physician's Profile

Full Name	Mr William Phillip Fortenberry Jr
Gender	Male
Speciality	Family Medicine
Location	50 Parkway Ln, Petal, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1235521923
Provider Enumeration Date: 03/04/2015
Last Update Date: 08/07/2023

Medicare PECOS Information:

PECOS PAC ID: 9436573433
Enrollment ID: I20230807003191

Medical Identifiers

Medical identifiers for Mr William Phillip Fortenberry Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1235521923	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	28846 (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. Mr William Phillip Fortenberry Jr allows following entities to bill medicare on his behalf.

Entity Name	Hattiesburg Clinic Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740213446 PECOS PAC ID: 5193706794 Enrollment ID: O20040528000685

Entity Name	Forrest County General Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295837631 PECOS PAC ID: 1052397767 Enrollment ID: O20040624001351

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 William Phillip Fortenberry Jr 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 William Phillip Fortenberry Jr, 415 S 28th Ave, Hattiesburg, MS 39401-7246 Ph: (601) 264-6000	Mr William Phillip Fortenberry Jr, 50 Parkway Ln, Petal, MS 39465-3035 Ph: (601) 544-7404

Reviews and Comments

Family Medicine Doctors in Petal, MS

Rodney N Lovitt, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 50 Parkway Ln, Petal, MS 39465 Phone: 601-544-7404 Fax: 601-584-6457
Patricia Lurline Campbell, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1146 Evelyn Gandy Pkwy, Petal, MS 39465 Phone: 601-584-4309
John Clayton Nelson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1146 Evelyn Gandy Pkwy, Petal, MS 39465 Phone: 601-584-4309
Ronald A Bullock, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 50 Parkway Ln, Petal, MS 39465 Phone: 601-705-2897 Fax: 601-584-6457
Donald V Conerly, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 50 Parkway Ln, Petal, MS 39465 Phone: 601-705-2897 Fax: 601-584-6457
Dr. Robert Michael Weaver, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1146 Evelyn Gandy Pkwy, Petal, MS 39465 Phone: 601-584-4309 Fax: 601-584-4890

Mr William Phillip Fortenberry Jr, - Medicare Family Medicine in Petal, MS