Charles Derrick Wilson, CRNA | |
4800 48th St, Valley, AL 36854-3666 | |
(334) 756-1848 | |
(334) 756-1854 |
Full Name | Charles Derrick Wilson |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 37 Years |
Location | 4800 48th St, Valley, Alabama |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730146309 | NPI | - | NPPES |
51517977 | Other | AL | BCBSAL PROVIDER # |
000549381E | Medicaid | GA | |
051517977 | Medicaid | AL | |
000549381C | Medicaid | GA | |
000549381D | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 1-044011 (Alabama) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | RN065069 (Georgia) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Catherine Hospital | Garden city, KS | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Us Anesthesia Partners Of Kansas Pa | 7719245299 | 15 |
Entity Name | Us Anesthesia Partners Of Kansas Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1811415599 PECOS PAC ID: 7719245299 Enrollment ID: O20171212000890 |
Mailing Address | Practice Location Address |
---|---|
Charles Derrick Wilson, CRNA Po Box 661495, Birmingham, AL 35266-1495 Ph: (205) 979-5882 | Charles Derrick Wilson, CRNA 4800 48th St, Valley, AL 36854-3666 Ph: (334) 756-1848 |
Thomas M Nichols, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 4800 48th St, Valley, AL 36854 Phone: 334-756-1848 Fax: 334-756-1854 | |
Mr. Gary Russell Mills, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4800 48th St, Valley, AL 36854 Phone: 256-283-7878 | |
Heather Laconya Veal Fields, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4800 48th St, Valley, AL 36854 Phone: 334-756-1848 Fax: 334-756-1854 | |
James M Henderson Jr., CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 4800 48th St, Valley, AL 36854 Phone: 334-756-1848 Fax: 334-756-1854 |