Tiffany L Lattimore, PA is a medicare enrolled "Physician Assistant" in Stanwood, Michigan. Her current practice location is
8354 100th Ave, Stanwood, Michigan. You can reach out to her office (for appointments etc.) via phone at
(231) 972-6000.
Tiffany L Lattimore is licensed to practice in Michigan (license number 5601006795) 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 1699104315.
Provider's Profile
Full Name | Tiffany L Lattimore |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 8354 100th Ave, Stanwood, Michigan |
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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: 1699104315
- Provider Enumeration Date: 11/04/2013
- Last Update Date: 06/15/2023
Medicare PECOS Information:
- PECOS PAC ID: 3678702016
- Enrollment ID: I20140206000912
Medical Identifiers
Medical identifiers for Tiffany L Lattimore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699104315 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 5601006795 (Michigan) | 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. Tiffany L Lattimore 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 |
Tiffany L Lattimore, PA 100 Michigan St Ne, Mc845, Grand Rapids, MI 49503-2560 Ph: (616) 486-6790 | Tiffany L Lattimore, PA 8354 100th Ave, Stanwood, MI 49346-8344 Ph: (231) 972-6000 |
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