Zackary Fordham, MD in Gulfport, MS - Medicare Emergency Medicine

Zackary Fordham, MD is a medicare enrolled "Emergency Medicine" physician in Gulfport, Mississippi. His current practice location is 4500 13th St, Gulfport, Mississippi. You can reach out to his office (for appointments etc.) via phone at (601) 672-3173.

Zackary Fordham is licensed to practice in Maine (license number MD18034) 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 1265589089.

Contact Information

	Zackary Fordham, MD
	4500 13th St, Gulfport, MS 39502
	(601) 672-3173
	Not Available

Map and Direction

Physician's Profile

Full Name	Zackary Fordham
Gender	Male
Speciality	Emergency Medicine
Location	4500 13th St, Gulfport, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1265589089
Provider Enumeration Date: 01/04/2007
Last Update Date: 10/16/2024

Medicare PECOS Information:

PECOS PAC ID: 5092897801
Enrollment ID: I20101122000082

Medical Identifiers

Medical identifiers for Zackary Fordham such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265589089	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	28369 (Alabama)	Secondary
207P00000X	Emergency Medicine	21091 (Mississippi)	Secondary
207P00000X	Emergency Medicine	MD18034 (Maine)	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. Zackary Fordham allows following entities to bill medicare on his behalf.

Entity Name	Memorial Hospital At Gulfport
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1215546635 PECOS PAC ID: 2466524012 Enrollment ID: O20090515000396

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. Zackary Fordham 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
Zackary Fordham, MD 4500 13th St, Po Box 1810, Gulfport, MS 39502 Ph: (601) 672-3173	Zackary Fordham, MD 4500 13th St, Gulfport, MS 39502 Ph: (601) 672-3173

Reviews and Comments

Emergency Medicine Doctors in Gulfport, MS

William H. Grover, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 4500 13th St, Gulfport, MS 39501 Phone: 228-865-3151 Fax: 228-867-4124
Mr. Charlton Paige Dennison, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 11446 Ashton Ln E, Gulfport, MS 39503 Phone: 205-344-2044
David Sawyer, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 4500 13th St, Gulfport, MS 39501 Phone: 228-865-3151 Fax: 228-867-4124
Dr. Debra Ann Hebert, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 15200 Community Rd, Gulfport, MS 39503 Phone: 228-575-7120 Fax: 228-575-7103
Dr. Martha Ann Dempsey, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1800 Beach Dr, Gulfport, MS 39507 Phone: 228-897-4450 Fax: 228-897-4450
Dr. Drew Weber, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 4500 13th St, Gulfport, MS 39501 Phone: 228-867-4000

Zackary Fordham, MD - Medicare Emergency Medicine in Gulfport, MS