Dolly Penn White, MD, MSCR - Medicare Preventive Medicine in Canton, GA

Dolly Penn White, MD, MSCR is a medicare enrolled "Preventive Medicine - Public Health & General Preventive Medicine" physician in Canton, Georgia. Her current practice location is 111 Mountain Brook Dr Ste 100, Canton, Georgia. You can reach out to her office (for appointments etc.) via phone at (678) 880-9654.

Dolly Penn White is licensed to practice in Georgia (license number 81812) 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 1669609442.

Contact Information

Dolly Penn White, MD, MSCR
111 Mountain Brook Dr Ste 100,
Canton, GA 30115-9045
(678) 880-9654
Not Available



Physician's Profile

Full NameDolly Penn White
GenderFemale
SpecialityPreventive Medicine - Public Health & General Preventive Medicine
Location111 Mountain Brook Dr Ste 100, Canton, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1669609442
  • Provider Enumeration Date: 06/18/2009
  • Last Update Date: 10/02/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 8123243581
  • Enrollment ID: I20210706002442

Medical Identifiers

Medical identifiers for Dolly Penn White such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1669609442NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2083P0901XPreventive Medicine - Public Health & General Preventive Medicine D81335 (Maryland)Secondary
208D00000XGeneral Practice 81812 (Georgia)Secondary
2083P0901XPreventive Medicine - Public Health & General Preventive Medicine 81812 (Georgia)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dolly Penn White allows following entities to bill medicare on her behalf.
Entity NameGood Samaritan Health Center Of Cobb
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1881923126
PECOS PAC ID: 7214970482
Enrollment ID: O20050608000595

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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. Dolly Penn White 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 AddressPractice Location Address
Dolly Penn White, MD, MSCR
111 Mountain Brook Dr Ste 100,
Canton, GA 30115-9045

Ph: (678) 880-9654
Dolly Penn White, MD, MSCR
111 Mountain Brook Dr Ste 100,
Canton, GA 30115-9045

Ph: (678) 880-9654

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Preventive Medicine Doctors in Canton, GA

Amira M Elsayed, M.D.
Preventive Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 495 Hickory Flat Hwy Ste 100, Canton, GA 30114
Phone: 678-341-6360    Fax: 678-626-7900

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