Wilson L Davis, MD is a medicare enrolled "Internal Medicine" physician in Tishomingo, Oklahoma. His current practice location is
610 E 24th St, Tishomingo, Oklahoma. You can reach out to his office (for appointments etc.) via phone at
(580) 371-2343.
Wilson L Davis is licensed to practice in Oklahoma (license number 34304) 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 1184633521.
Physician's Profile
| Full Name | Wilson L Davis |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Location | 610 E 24th St, Tishomingo, Oklahoma |
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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: 1184633521
- Provider Enumeration Date: 08/05/2006
- Last Update Date: 12/19/2022
Medicare PECOS Information:
- PECOS PAC ID: 6901717131
- Enrollment ID: I20181210001042
Medical Identifiers
Medical identifiers for Wilson L Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1184633521 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | 34304 (Oklahoma) | 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. Wilson L Davis allows following entities to bill medicare on his behalf.
| Entity Name | Family Health Center Of Southern Oklahoma Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1598803942
PECOS PAC ID: 4284537457
Enrollment ID: O20040127001108 |
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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. Wilson L Davis 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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Wilson L Davis, MD
610 E 24th St,
Tishomingo, OK 73460-3245
Ph: (580) 371-2343 | Wilson L Davis, MD
610 E 24th St,
Tishomingo, OK 73460
Ph: (580) 371-2343 |
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