Mr Chris Chadwick Fugate, CRNA | |
256 N 2nd E, Rexburg, ID 83440-1638 | |
(208) 656-9646 | |
Not Available |
Full Name | Mr Chris Chadwick Fugate |
---|---|
Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 256 N 2nd E, Rexburg, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174693543 | NPI | - | NPPES |
0043670 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | N-16877 (Idaho) | Primary |
Entity Name | Madison Anesthesia Services Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558392571 PECOS PAC ID: 9739174152 Enrollment ID: O20040415001317 |
Entity Name | Anesthesia West Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1639238439 PECOS PAC ID: 4981884533 Enrollment ID: O20110214000880 |
Mailing Address | Practice Location Address |
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Mr Chris Chadwick Fugate, CRNA Po Box 3659, Idaho Falls, ID 83403-3659 Ph: (208) 525-2090 | Mr Chris Chadwick Fugate, CRNA 256 N 2nd E, Rexburg, ID 83440-1638 Ph: (208) 656-9646 |
Todd Gehmlich, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 450 E Main St, Rexburg, ID 83440 Phone: 208-356-3691 | |
Jeffrey T Grover, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 450 E Main St, Rexburg, ID 83440 Phone: 208-356-3691 | |
Cindi Farnworth, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 450 E Main St, Rexburg, ID 83440 Phone: 208-356-3691 | |
William J Houlihan, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 450 E Main St, Rexburg, ID 83440 Phone: 208-356-3691 | |
Barton J Hunt, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 450 E Main St, Rexburg, ID 83440 Phone: 208-359-6564 | |
Mr. Michael B. Karren, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 450 E Main St, Rexburg, ID 83440 Phone: 208-359-6564 |