Donovan Dean Wilson, | |
1 Medical Park Blvd, Bristol, TN 37620-7430 | |
(423) 844-1121 | |
Not Available |
Full Name | Donovan Dean Wilson |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 40 Years |
Location | 1 Medical Park Blvd, Bristol, Tennessee |
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 |
---|---|---|---|
1093743726 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 112090 (Texas) | Primary |
367500000X | Nurse Anesthetist, Certified Registered | 37086 (Tennessee) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Wellmont Bristol Regional Medical Center | Bristol, TN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Paragon Anesthesia Pc | 8921044744 | 114 |
Entity Name | Paragon Anesthesia Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538174974 PECOS PAC ID: 8921044744 Enrollment ID: O20090402000626 |
Entity Name | Wellmont Medical Associates Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780986257 PECOS PAC ID: 8123291739 Enrollment ID: O20111026000909 |
Mailing Address | Practice Location Address |
---|---|
Donovan Dean Wilson, 350 Blountville Hwy, Ste 207, Bristol, TN 37620-0213 Ph: (423) 968-4540 | Donovan Dean Wilson, 1 Medical Park Blvd, Bristol, TN 37620-7430 Ph: (423) 844-1121 |
Cassondra Nichole Compton, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Park Blvd, Bristol, TN 37620 Phone: 423-844-2686 Fax: 423-844-2688 | |
Saralee A Bailey, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 236 Alhambra Dr, Bristol, TN 37620 Phone: 423-383-8395 | |
Robert R Herndon, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Park Blvd, Bristol, TN 37620 Phone: 423-844-1121 | |
Rolf H Jarnes, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Park Blvd, Bristol, TN 37620 Phone: 423-844-1121 | |
Jennifer Elaine Mays, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Park Blvd, Bristol, TN 37620 Phone: 423-844-2686 Fax: 423-844-2688 | |
Amanda Suzanne Gaither, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 350 Blountville Hwy, Suite 207, Bristol, TN 37620 Phone: 423-968-4540 Fax: 423-968-5697 |