Mr Horace Michael Delisser Jr, PA is a medicare enrolled "Physician Assistant - Surgical" in Bethlehem, Georgia. His current practice location is
426 Exchange Blvd Ste 600, Bethlehem, Georgia. You can reach out to his office (for appointments etc.) via phone at
(770) 848-6190.
Mr Horace Michael Delisser Jr is licensed to practice in Georgia (license number 11352) 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 1306357256.
Provider's Profile
| Full Name | Mr Horace Michael Delisser Jr |
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| Gender | Male |
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| Speciality | Physician Assistant - Surgical |
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| Location | 426 Exchange Blvd Ste 600, Bethlehem, Georgia |
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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: 1306357256
- Provider Enumeration Date: 10/18/2017
- Last Update Date: 01/16/2023
Medicare PECOS Information:
- PECOS PAC ID: 9032478789
- Enrollment ID: I20180125002129
Medical Identifiers
Medical identifiers for Mr Horace Michael Delisser Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306357256 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363AS0400X | Physician Assistant - Surgical | (* (Not Available)) | Secondary |
| 363AS0400X | Physician Assistant - Surgical | 11352 (Georgia) | Primary |
| 363AS0400X | Physician Assistant - Surgical | MA059415 (Pennsylvania) | Secondary |
| 363AS0400X | Physician Assistant - Surgical | 25MP00494800 (New Jersey) | Secondary |
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. Mr Horace Michael Delisser Jr 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 |
|---|
Mr Horace Michael Delisser Jr, PA
Po Box 742616,
Atlanta, GA 30374-2616
Ph: (770) 219-8420 | Mr Horace Michael Delisser Jr, PA
426 Exchange Blvd Ste 600,
Bethlehem, GA 30620-1794
Ph: (770) 848-6190 |
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