Dr Raymond Joseph Clydesdale, DO is a medicare enrolled "Preventive Medicine - Aerospace Medicine" physician in Scott Afb, Illinois. His current practice location is
375 Medical Group, 310 W. Losey Street, Scott Afb, Illinois. You can reach out to his office (for appointments etc.) via phone at
(618) 256-9355.
Dr Raymond Joseph Clydesdale is licensed to practice in Pennsylvania (license number OS12364) 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 1699764340.
Physician's Profile
Full Name | Dr Raymond Joseph Clydesdale |
---|
Gender | Male |
---|
Speciality | Preventive Medicine - Aerospace Medicine |
---|
Location | 375 Medical Group, Scott Afb, Illinois |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1699764340
- Provider Enumeration Date: 10/17/2005
- Last Update Date: 01/26/2023
Medicare PECOS Information:
- PECOS PAC ID: 3375893852
- Enrollment ID: I20180904001560
Medical Identifiers
Medical identifiers for Dr Raymond Joseph Clydesdale such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699764340 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2083X0100X | Preventive Medicine - Occupational Medicine | OS12364 (Pennsylvania) | Secondary |
2083A0100X | Preventive Medicine - Aerospace Medicine | OS12364 (Pennsylvania) | 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. Dr Raymond Joseph Clydesdale 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 Raymond Joseph Clydesdale, DO 375 Medical Group, 310 W. Losey Street, Scott Afb, IL 62225 Ph: (618) 256-9355 | Dr Raymond Joseph Clydesdale, DO 375 Medical Group, 310 W. Losey Street, Scott Afb, IL 62225 Ph: (618) 256-9355 |
Reviews and Comments