Ricky O Tatum, PAC in Waycross, GA - Medicare Physician Assistant

Ricky O Tatum, PAC is a medicare enrolled "Physician Assistant" in Waycross, Georgia. His current practice location is 1007 Mary St, Waycross, Georgia. You can reach out to his office (for appointments etc.) via phone at (912) 449-8601.

Ricky O Tatum is licensed to practice in Georgia (license number 002235) 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 1073837555.

Contact Information

	Ricky O Tatum, PAC
	1007 Mary St, Waycross, GA 31503-3823
	(912) 449-8601
	(912) 449-7060

Provider's Profile

Full Name	Ricky O Tatum
Gender	Male
Speciality	Physician Assistant
Location	1007 Mary St, Waycross, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073837555
Provider Enumeration Date: 03/26/2010
Last Update Date: 03/26/2010

Medicare PECOS Information:

PECOS PAC ID: 0042340630
Enrollment ID: I20100608000568

Medical Identifiers

Medical identifiers for Ricky O Tatum such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073837555	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	002235 (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. Ricky O Tatum 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
Ricky O Tatum, PAC 1007 Mary St, Waycross, GA 31503-3823 Ph: (912) 449-8601	Ricky O Tatum, PAC 1007 Mary St, Waycross, GA 31503-3823 Ph: (912) 449-8601

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Physician Assistant Nurses in Waycross, GA

Tayler Hutto Allen, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2005 Pioneer St, Waycross, GA 31501 Phone: 912-490-7777 Fax: 912-490-7779
Kimberly Cecil, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1218 Alice St, Waycross, GA 31501 Phone: 912-590-0973 Fax: 912-590-0180
Laken Renee Tanner, MSPAP, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1900 Tebeau St, Waycross, GA 31501 Phone: 912-283-3030
Mrs. Hannah Carter Horner, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 218 Quarterman St, Waycross, GA 31501 Phone: 912-287-0301 Fax: 912-287-1568
John Franklin Jacobs, PHYSICIAN ASSISTANT Physician Assistant Medicare: Medicare Enrolled Practice Location: 410 Darling Ave, Waycross, GA 31501 Phone: 912-287-2744 Fax: 912-338-6538
Amanda S Smith, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 700 Riverside Ave, Waycross, GA 31501 Phone: 912-490-8546 Fax: 877-221-0052

Ricky O Tatum, PAC - Medicare Physician Assistant in Waycross, GA