Ian Prudhomme, MD is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in Apo, Armed Forces Americas. He went to Uniformed Services Uhs Fe Hebert School Of Med and graduated in 2016 and has 10 years of diverse experience with area of expertise as Pathology. He is a member of the group practice Integrated Regional Laboratories Pathology Services, Llc and his current practice location is
2200 Bergquist Dr Ste 1, Whmc/ge-2200, Jbsa Lackland Afb, Tx, Apo, Armed Forces Americas. You can reach out to his office (for appointments etc.) via phone at
(423) 943-2720.
Ian Prudhomme is licensed to practice in Nebraska (license number 30410) 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 1780044362.
Physician's Profile
| Full Name | Ian Prudhomme |
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| Gender | Male |
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| Speciality | Pathology |
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| Experience | 10 Years |
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| Location | 2200 Bergquist Dr Ste 1, Apo, Armed Forces Americas |
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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:
- Ian Prudhomme attended and graduated from Uniformed Services Uhs Fe Hebert School Of Med in 2016
NPI Data:
- NPI Number: 1780044362
- Provider Enumeration Date: 02/25/2016
- Last Update Date: 01/08/2024
Medicare PECOS Information:
- PECOS PAC ID: 3678054103
- Enrollment ID: I20260223004045
Medical Identifiers
Medical identifiers for Ian Prudhomme such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1780044362 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 30410 (Nebraska) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Integrated Regional Laboratories Pathology Services, Llc | 9133244346 | 134 |
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. Ian Prudhomme 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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Ian Prudhomme, MD
2200 Bergquist Dr Ste 1, Whmc/ge-2200,
Jbsa Lackland Afb, TX 78236-5300
Ph: () - | Ian Prudhomme, MD
2200 Bergquist Dr Ste 1, Whmc/ge-2200, Jbsa Lackland Afb, Tx,
Apo, AA 78236-5300
Ph: (423) 943-2720 |
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