Dewitt Charles Fortenberry, MD is a medicare enrolled "General Practice" physician in Texarkana, Texas. He went to Johns Hopkins University School Of Medicine and graduated in 1990 and has 35 years of diverse experience with area of expertise as Internal Medicine. His current practice location is
2602 Saint Michael Dr, Suite 302, Texarkana, Texas. You can reach out to his office (for appointments etc.) via phone at
(903) 336-2391.
Dewitt Charles Fortenberry is licensed to practice in Texas (license number L8691) 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 1114960473.
Physician's Profile
| Full Name | Dewitt Charles Fortenberry |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Experience | 35 Years |
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| Location | 2602 Saint Michael Dr, Texarkana, Texas |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dewitt Charles Fortenberry attended and graduated from Johns Hopkins University School Of Medicine in 1990
NPI Data:
- NPI Number: 1114960473
- Provider Enumeration Date: 06/14/2006
- Last Update Date: 09/17/2023
Medicare PECOS Information:
- PECOS PAC ID: 7315919925
- Enrollment ID: I20040812000544
Medical Identifiers
Medical identifiers for Dewitt Charles Fortenberry such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114960473 | NPI | - | NPPES |
| 167594401 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | L8691 (Texas) | Secondary |
| 208D00000X | General Practice | L8691 (Texas) | Primary |
Medical Facilities Affiliation
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. Dewitt Charles Fortenberry allows following entities to bill medicare on his behalf.
| Entity Name | Medeval, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1740548346
PECOS PAC ID: 9537319256
Enrollment ID: O20121015000495 |
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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. Dewitt Charles Fortenberry 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 |
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Dewitt Charles Fortenberry, MD
116 Westlake Rd,
Texarkana, TX 75501-0006
Ph: (903) 293-7093 | Dewitt Charles Fortenberry, MD
2602 Saint Michael Dr, Suite 302,
Texarkana, TX 75503-2387
Ph: (903) 336-2391 |
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