Mrs Wanda B Liddell, ARNP is a medicare enrolled "Family Medicine" physician in Cross City, Florida. Her current practice location is
306 Ne Hwy 351, Cross City, Florida. You can reach out to her office (for appointments etc.) via phone at
(352) 498-3372.
Mrs Wanda B Liddell is licensed to practice in Florida (license number 1569472) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1649346271.
Physician's Profile
| Full Name | Mrs Wanda B Liddell |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 306 Ne Hwy 351, Cross City, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1649346271
- Provider Enumeration Date: 11/27/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 2567373384
- Enrollment ID: I20041014000290
Medical Identifiers
Medical identifiers for Mrs Wanda B Liddell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1649346271 | NPI | - | NPPES |
| Y7250 | Other | FL | BCBS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 1569472 (Florida) | 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. Mrs Wanda B Liddell allows following entities to bill medicare on her behalf.
| Entity Name | Tri-county Primary Care Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437225067
PECOS PAC ID: 7214848027
Enrollment ID: O20040608000271 |
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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. Mrs Wanda B Liddell 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 |
|---|
Mrs Wanda B Liddell, ARNP
306 Ne Hwy 351,
Cross City, FL 32628
Ph: (352) 498-3372 | Mrs Wanda B Liddell, ARNP
306 Ne Hwy 351,
Cross City, FL 32628
Ph: (352) 498-3372 |
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