Deananne D Fordham, PAC is a medicare enrolled "Physician Assistant - Medical" in Eastman, Georgia. Her current practice location is
1223 Plaza Ave, Eastman, Georgia. You can reach out to her office (for appointments etc.) via phone at
(478) 374-3814.
Deananne D Fordham is licensed to practice in Georgia (license number 003393) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1215904446.
Provider's Profile
Full Name | Deananne D Fordham |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 1223 Plaza Ave, Eastman, Georgia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1215904446
- Provider Enumeration Date: 03/07/2006
- Last Update Date: 07/09/2007
Medicare PECOS Information:
- PECOS PAC ID: 4688759939
- Enrollment ID: I20080311000221
Medical Identifiers
Medical identifiers for Deananne D Fordham such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1215904446 | NPI | - | NPPES |
100001203A | Medicaid | GA | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AM0700X | Physician Assistant - Medical | 003393 (Georgia) | 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. Deananne D 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 |
Deananne D Fordham, PAC Rr 1 Box 60, Chester, GA 31012-9501 Ph: (478) 358-9436 | Deananne D Fordham, PAC 1223 Plaza Ave, Eastman, GA 31023-6763 Ph: (478) 374-3814 |
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