Ava Rose Dettore, PA is a
Physician Assistant based in Red Bank, Tennessee. Ava Rose Dettore is licensed to practice in Tennessee (license number 6179) and her current practice location is
4104 Dayton Blvd, Red Bank, Tennessee. She can be reached at her office (for appointments etc.) via phone at
(423) 499-7710.
NPI number for Ava Rose Dettore is 1295562106 and her current mailing address is 4104 Dayton Blvd, Red Bank, Tennessee. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1295562106.
Provider's Profile
Full Name | Ava Rose Dettore |
---|
Gender | Female |
---|
Speciality | Physician Assistant |
---|
Location | 4104 Dayton Blvd, Red Bank, Tennessee |
---|
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1295562106
- Provider Enumeration Date: 09/16/2024
- Last Update Date: 09/16/2024
Medical Identifiers
Medical identifiers for Ava Rose Dettore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1295562106 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 6179 (Tennessee) | 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. Ava Rose Dettore is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ava Rose Dettore, PA 4104 Dayton Blvd, Red Bank, TN 37415-7155 Ph: (423) 499-7710 | Ava Rose Dettore, PA 4104 Dayton Blvd, Red Bank, TN 37415-7155 Ph: (423) 499-7710 |
Reviews and Comments