Jeffry Lynes Peterson, CRNA | |
10117 Pine Crest Rd, Red Bud, IL 62278-4458 | |
(618) 282-2872 | |
Not Available |
Full Name | Jeffry Lynes Peterson |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 27 Years |
Location | 10117 Pine Crest Rd, Red Bud, Illinois |
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 |
---|---|---|---|
1164569729 | NPI | - | NPPES |
7424890700 | Medicaid | KY |
Facility Name | Location | Facility Type |
---|---|---|
Memorial Hospital | Chester, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Memorial Hospital | 5294649372 | 18 |
Entity Name | Memorial Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851390132 PECOS PAC ID: 5294649372 Enrollment ID: O20031113000382 |
Entity Name | Good Samaritan Regional Health Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487758801 PECOS PAC ID: 1658272059 Enrollment ID: O20040119000325 |
Entity Name | St Marys Hospital Centralia Illinois |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770687196 PECOS PAC ID: 6709788920 Enrollment ID: O20040127000118 |
Entity Name | Sparta Community Hospital D/b/a Quality Healthcare Clinics |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114984226 PECOS PAC ID: 6709870462 Enrollment ID: O20040414000594 |
Entity Name | Sparta Community Hospital |
---|---|
Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1548216476 PECOS PAC ID: 3971408295 Enrollment ID: O20071002000435 |
Mailing Address | Practice Location Address |
---|---|
Jeffry Lynes Peterson, CRNA 10117 Pine Crest Rd, Red Bud, IL 62278-4458 Ph: (270) 898-1922 | Jeffry Lynes Peterson, CRNA 10117 Pine Crest Rd, Red Bud, IL 62278-4458 Ph: (618) 282-2872 |
Mr. Earl Gene Draves, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 325 Spring St, Red Bud, IL 62278 Phone: 618-282-3831 Fax: 618-282-1919 |