Ian Prudhomme, MD is a
Pathology - Anatomic Pathology & Clinical Pathology physician based in Apo, Armed Forces Americas. Ian Prudhomme is licensed to practice in Nebraska (license number 30410) and his current practice location is 2200 Bergquist Dr Ste 1, Whmc/ge-2200, Jbsa Lackland Afb, Tx, Apo, Armed Forces Americas. He can be reached at his office (for appointments etc.) via phone at
(423) 943-2720.
NPI number for Ian Prudhomme is 1780044362 and his current mailing address is 2200 Bergquist Dr Ste 1, Whmc/ge-2200, Jbsa Lackland Afb, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1780044362.
Physician's Profile
| Full Name | Ian Prudhomme |
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| Gender | Male |
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| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
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| Location | 2200 Bergquist Dr Ste 1, Apo, Armed Forces Americas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1780044362
- Provider Enumeration Date: 02/25/2016
- Last Update Date: 01/08/2024
Medical Identifiers
Medical identifiers for Ian Prudhomme such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780044362 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 30410 (Nebraska) | 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. Ian Prudhomme is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
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 |