Mallory Stephens Tatum, PA is a medicare enrolled "Physician Assistant" in Lakeland, Tennessee. Her current practice location is
9160 Highway 64 Ste 105, Lakeland, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(901) 213-0100.
Mallory Stephens Tatum is licensed to practice in Tennessee (license number 3352) 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 1467978403.
Provider's Profile
| Full Name | Mallory Stephens Tatum |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 9160 Highway 64 Ste 105, Lakeland, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1467978403
- Provider Enumeration Date: 08/22/2017
- Last Update Date: 03/26/2020
Medicare PECOS Information:
- PECOS PAC ID: 0840564506
- Enrollment ID: I20170928002449
Medical Identifiers
Medical identifiers for Mallory Stephens Tatum such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1467978403 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 3352 (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. Mallory Stephens Tatum 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 |
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Mallory Stephens Tatum, PA
8016 Ellis Rd,
Bartlett, TN 38133-2806
Ph: (662) 322-9442 | Mallory Stephens Tatum, PA
9160 Highway 64 Ste 105,
Lakeland, TN 38002-3011
Ph: (901) 213-0100 |
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