Jeffrey J Ickler, MD is a medicare enrolled "Surgery" physician in Diberville, Mississippi. His current practice location is
10241 Boney Ave Ste A, Diberville, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(228) 967-7651.
Jeffrey J Ickler is licensed to practice in Alabama (license number 00022258) 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 1477656528.
Physician's Profile
Full Name | Jeffrey J Ickler |
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Gender | Male |
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Speciality | Surgery |
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Location | 10241 Boney Ave Ste A, Diberville, Mississippi |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1477656528
- Provider Enumeration Date: 09/06/2006
- Last Update Date: 05/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 5395928394
- Enrollment ID: I20110329000847
Medical Identifiers
Medical identifiers for Jeffrey J Ickler such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1477656528 | NPI | - | NPPES |
009998120 | Medicaid | AL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | 00022258 (Alabama) | 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. Jeffrey J Ickler 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 |
Jeffrey J Ickler, MD 10241 Boney Ave Ste A, Diberville, MS 39540-4889 Ph: (228) 967-7651 | Jeffrey J Ickler, MD 10241 Boney Ave Ste A, Diberville, MS 39540-4889 Ph: (228) 967-7651 |
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