Dr Jeryl Glynn Fullen, MD in Logansport, IN - Medicare Orthopaedic Surgery

Dr Jeryl Glynn Fullen, MD is a medicare enrolled "Orthopaedic Surgery" physician in Logansport, Indiana. His current practice location is 1101 Michigan Ave, Logansport, Indiana. You can reach out to his office (for appointments etc.) via phone at (574) 753-1729.

Dr Jeryl Glynn Fullen is licensed to practice in Indiana (license number 01063517A) 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 1275631020.

Contact Information

	Dr Jeryl Glynn Fullen, MD
	1101 Michigan Ave, Logansport, IN 46947-1528
	(574) 753-1729
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Jeryl Glynn Fullen
Gender	Male
Speciality	Orthopaedic Surgery
Location	1101 Michigan Ave, Logansport, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1275631020
Provider Enumeration Date: 09/20/2006
Last Update Date: 01/16/2014

Medicare PECOS Information:

PECOS PAC ID: 6507803400
Enrollment ID: I20091008000493

Medical Identifiers

Medical identifiers for Dr Jeryl Glynn Fullen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1275631020	NPI	-	NPPES
200993900	Medicaid	IN
000000696600	Other	IN	ANTHEM
5N934	Other	AR	MEDICARE PTAN
100118960A	Medicaid	KS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207X00000X	Orthopaedic Surgery	04-16478 (Kansas)	Secondary
207X00000X	Orthopaedic Surgery	01063517A (Indiana)	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. Dr Jeryl Glynn Fullen allows following entities to bill medicare on his behalf.

Entity Name	Southeast Missouri Hospital Physicians Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558311522 PECOS PAC ID: 9133024334 Enrollment ID: O20031201000775

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 Jeryl Glynn Fullen 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
Dr Jeryl Glynn Fullen, MD 1101 Michigan Ave, Logansport, IN 46947-1528 Ph: (574) 753-1729	Dr Jeryl Glynn Fullen, MD 1101 Michigan Ave, Logansport, IN 46947-1528 Ph: (574) 753-1729

Reviews and Comments

Orthopaedic Surgery Doctors in Logansport, IN

Kral Varhan, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1101 Michigan Ave, Logansport, IN 46947 Phone: 574-722-2663
Dr. Ganeshan Ramachandran, DO Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1101 Michigan Ave, Logansport, IN 46947 Phone: 574-722-2663 Fax: 574-753-1729
Dr. James R Davis, DO Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 1101 Michigan Ave, Logansport, IN 46947 Phone: 574-722-2663

Dr Jeryl Glynn Fullen, MD - Medicare Orthopaedic Surgery in Logansport, IN