Jacob Tibbs, CRNA | |
122 12th Street Ext, Princeton, WV 24740-2352 | |
(304) 487-7000 | |
Not Available |
Full Name | Jacob Tibbs |
---|---|
Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 122 12th Street Ext, Princeton, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548901739 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 0001282301 (Virginia) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 113030 (West Virginia) | Primary |
Entity Name | East River Anesthesiology Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740711795 PECOS PAC ID: 2961770169 Enrollment ID: O20170612002178 |
Mailing Address | Practice Location Address |
---|---|
Jacob Tibbs, CRNA Po Box 7023, Princeton, WV 24740-0197 Ph: () - | Jacob Tibbs, CRNA 122 12th Street Ext, Princeton, WV 24740-2352 Ph: (304) 487-7000 |
Mrs. Mary K Roberts, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 109 Morrison Dr, Princeton, WV 24740 Phone: 304-487-3559 Fax: 304-487-7928 | |
Mrs. Caressa Rae Southers, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 109 Morrison Dr, Princeton, WV 24740 Phone: 304-487-3559 Fax: 304-487-7928 | |
Mrs. Michele E Smith, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 405 12th Street Ext, Princeton, WV 24740 Phone: 304-425-7243 Fax: 304-487-3525 | |
Ronald Beatty, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 109 Morrison Dr, Princeton, WV 24740 Phone: 304-487-3559 Fax: 304-487-7928 | |
Mrs. Maxine Dempsey, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 65 New Hope Rd, Princeton, WV 24740 Phone: 304-425-9724 | |
Johnnie Johns, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 109 Morrison Dr, Princeton, WV 24740 Phone: 304-487-3559 Fax: 304-487-7928 |