Nicholas Carroll Destefano, MD in Fort Gordon, GA

Nicholas Carroll Destefano, MD is a medicare enrolled "General Practice" physician in Fort Gordon, Georgia. His current practice location is 300 E Hospital Rd, Fort Gordon, Georgia. You can reach out to his office (for appointments etc.) via phone at (706) 383-5299.

Nicholas Carroll Destefano is licensed to practice in Nebraska (license number 30177) 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 1154776755.

Contact Information

	Nicholas Carroll Destefano, MD
	300 E Hospital Rd, Fort Gordon, GA 30905
	(706) 383-5299
	Not Available

Map and Direction

Physician's Profile

Full Name	Nicholas Carroll Destefano
Gender	Male
Speciality	General Practice
Location	300 E Hospital Rd, Fort Gordon, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1154776755
Provider Enumeration Date: 05/02/2016
Last Update Date: 09/20/2023

Medicare PECOS Information:

PECOS PAC ID: 0446542229
Enrollment ID: I20170802002850

Medical Identifiers

Medical identifiers for Nicholas Carroll Destefano such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154776755	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208D00000X	General Practice	30177 (Nebraska)	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. Nicholas Carroll Destefano 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
Nicholas Carroll Destefano, MD 300 E Hospital Rd, Fort Gordon, GA 30905 Ph: (706) 383-5299	Nicholas Carroll Destefano, MD 300 E Hospital Rd, Fort Gordon, GA 30905 Ph: (706) 383-5299

Reviews and Comments

General Practice Doctors in Fort Gordon, GA

Phillip Joseph Markey, MD General Practice Medicare: Medicare Enrolled Practice Location: 300 E Hospital Rd, Fort Gordon, GA 30905 Phone: 706-787-9399
Dr. Darrell Faubert Barker, M.D. General Practice Medicare: Medicare Enrolled Practice Location: 300 East Hospital Road, Fort Gordon, GA 30905 Phone: 706-836-9829
Dr. Logan Lauderdale Wallace, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 300 East Hospital Road, Fort Gordon, GA 30905 Phone: 707-786-5811

Nicholas Carroll Destefano, MD - Medicare General Practice in Fort Gordon, GA