| Donald R Ford, MD | |
|
600 N College Ave, Suite 120, Geneseo, IL 61254-1091 | |
| (309) 944-5342 | |
| (309) 944-8192 |
| Full Name | Donald R Ford |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 600 N College Ave, Geneseo, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053398933 | NPI | - | NPPES |
| 0360476613 | Medicaid | IL | |
| 0801777765 | Other | IL | RR MEDICARE |
| 1053398933 | Medicaid | IL | |
| 036047661 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25736 (Iowa) | Secondary |
| 207Q00000X | Family Medicine | 036047661 (Illinois) | Primary |
| Entity Name | County Of Henry |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851394829 PECOS PAC ID: 5193828556 Enrollment ID: O20070306000229 |
| Entity Name | Hammond Henry Dist Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629517313 PECOS PAC ID: 0143115949 Enrollment ID: O20170511000385 |
| Mailing Address | Practice Location Address |
|---|---|
| Donald R Ford, MD 600 N College Ave, Suite 120, Geneseo, IL 61254-1091 Ph: (309) 944-5342 | Donald R Ford, MD 600 N College Ave, Suite 120, Geneseo, IL 61254-1091 Ph: (309) 944-5342 |
Elyse Wolf, APN Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 N College Ave, Geneseo, IL 61254 Phone: 309-944-6431 | |
Shari L Becker, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 600 N College Ave, Suite 120, Geneseo, IL 61254 Phone: 309-944-5342 Fax: 309-944-8192 |