Dr Odilichi Ezenwanne, MD - Medicare Family Practice in Tunica, MS

Dr Odilichi Ezenwanne, MD is a medicare enrolled "Preventive Medicine - Public Health & General Preventive Medicine" physician in Tunica, Mississippi. He graduated from medical school in 2001 and has 23 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Aaron E Henry Community Health and his current practice location is 1820 Peabody St, Tunica, Mississippi. You can reach out to his office (for appointments etc.) via phone at (662) 363-3656.

Dr Odilichi Ezenwanne is licensed to practice in Wisconsin (license number 67275) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1841504206.

Contact Information

Dr Odilichi Ezenwanne, MD
1820 Peabody St,
Tunica, MS 38676-9441
(662) 363-3656
Not Available



Physician's Profile

Full NameDr Odilichi Ezenwanne
GenderMale
SpecialityFamily Practice
Experience23 Years
Location1820 Peabody St, Tunica, Mississippi
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Odilichi Ezenwanne graduated from medical school in 2001
  NPI Data:
  • NPI Number: 1841504206
  • Provider Enumeration Date: 07/27/2010
  • Last Update Date: 02/18/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 6406127265
  • Enrollment ID: I20191220001793

Medical Identifiers

Medical identifiers for Dr Odilichi Ezenwanne such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1841504206NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2083P0901XPreventive Medicine - Public Health & General Preventive Medicine 27125 (Mississippi)Secondary
2083P0901XPreventive Medicine - Public Health & General Preventive Medicine 67275 (Wisconsin)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Aaron E Henry Community Health11532305609

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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. Dr Odilichi Ezenwanne allows following entities to bill medicare on his behalf.
Entity NameAaron E Henry Community Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003814104
PECOS PAC ID: 1153230560
Enrollment ID: O20040330001267

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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. Dr Odilichi Ezenwanne 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
Dr Odilichi Ezenwanne, MD
1820 Peabody St,
Tunica, MS 38676-9441

Ph: (662) 363-3656
Dr Odilichi Ezenwanne, MD
1820 Peabody St,
Tunica, MS 38676-9441

Ph: (662) 363-3656

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Preventive Medicine Doctors in Tunica, MS


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