Mr Michael Keene Demack, PA C S is a medicare enrolled "Physician Assistant - Medical" physician in Payson, Arizona. His current practice location is
806 S Ponderosa St, Payson, Arizona. You can reach out to his office (for appointments etc.) via phone at
(928) 468-8603.
Mr Michael Keene Demack is licensed to practice in Arizona (license number 6422) 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 1043347313.
Physician's Profile
| Full Name | Mr Michael Keene Demack |
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| Gender | Male |
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| Speciality | Physician Assistant - Medical |
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| Location | 806 S Ponderosa St, Payson, Arizona |
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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: 1043347313
- Provider Enumeration Date: 02/27/2007
- Last Update Date: 04/19/2017
Medicare PECOS Information:
- PECOS PAC ID: 9739457631
- Enrollment ID: I20170619000691
Medical Identifiers
Medical identifiers for Mr Michael Keene Demack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1043347313 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | PA 14934 (California) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 6422 (Arizona) | 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. Mr Michael Keene Demack 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 |
Mr Michael Keene Demack, PA C S Po Box 2901, Payson, AZ 85547-2901 Ph: (928) 468-8603 | Mr Michael Keene Demack, PA C S 806 S Ponderosa St, Payson, AZ 85541-5541 Ph: (928) 468-8603 |
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