Mrs Phyllis Wrenn Sackariasen, PA-C is a
Physician Assistant based in Sugar Valley, Georgia. Mrs Phyllis Wrenn Sackariasen is licensed to practice in Georgia (license number 002147) and her current practice location is
3090 Sugar Valley Rd Nw, Sugar Valley, Georgia. She can be reached at her office (for appointments etc.) via phone at
(706) 624-4661.
NPI number for Mrs Phyllis Wrenn Sackariasen is 1205824760 and her current mailing address is 3090 Sugar Valley Rd Nw, Sugar Valley, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1205824760.
Provider's Profile
| Full Name | Mrs Phyllis Wrenn Sackariasen |
|---|
| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 3090 Sugar Valley Rd Nw, Sugar Valley, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1205824760
- Provider Enumeration Date: 10/10/2005
- Last Update Date: 03/07/2023
Medical Identifiers
Medical identifiers for Mrs Phyllis Wrenn Sackariasen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205824760 | NPI | - | NPPES |
| 236050967A | Medicaid | GA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 002147 (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. Mrs Phyllis Wrenn Sackariasen 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 |
|---|
Mrs Phyllis Wrenn Sackariasen, PA-C
3090 Sugar Valley Rd Nw,
Sugar Valley, GA 30746-5166
Ph: (706) 624-4661 | Mrs Phyllis Wrenn Sackariasen, PA-C
3090 Sugar Valley Rd Nw,
Sugar Valley, GA 30746-5166
Ph: (706) 624-4661 |
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