Jason Tibbett, CRNA | |
200 Tyler St, West Memphis, AR 72301 | |
(870) 735-1500 | |
(870) 733-3861 |
Full Name | Jason Tibbett |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 13 Years |
Location | 200 Tyler St, West Memphis, Arkansas |
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 |
---|---|---|---|
1790084028 | NPI | - | NPPES |
169954 | Other | TN LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | AP07594 (Louisiana) | Primary |
367500000X | Nurse Anesthetist, Certified Registered | 169954 (Tennessee) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Specialists Hospital Shreveport | Shreveport, LA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Novus Louisiana Medical Professional Corporation | 5395194880 | 23 |
Entity Name | Mid-louisiana Anesthesia Consultants, Apmc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205888914 PECOS PAC ID: 3971408733 Enrollment ID: O20031204000583 |
Entity Name | Natchitoches Anesthesia Associates Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1992827182 PECOS PAC ID: 4981591088 Enrollment ID: O20040303000373 |
Entity Name | Medical Center Anesthesiologists |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669469748 PECOS PAC ID: 6608814843 Enrollment ID: O20050419001114 |
Entity Name | Novus Louisiana Medical Professional Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336926872 PECOS PAC ID: 5395194880 Enrollment ID: O20231208002673 |
Mailing Address | Practice Location Address |
---|---|
Jason Tibbett, CRNA Po Box 5887, Alexandria, LA 71307-5887 Ph: (870) 735-1500 | Jason Tibbett, CRNA 200 Tyler St, West Memphis, AR 72301 Ph: (870) 735-1500 |
Mr. Tommy Lee Fair, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 200 W Tyler Ave, West Memphis, AR 72301 Phone: 870-735-1500 Fax: 870-733-3861 |