Mr Jacob Troy Russell, CRNA | |
807 S Ponderosa St, Payson, AZ 85541-5542 | |
(928) 472-1273 | |
Not Available |
Full Name | Mr Jacob Troy Russell |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 8 Years |
Location | 807 S Ponderosa St, Payson, Arizona |
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 |
---|---|---|---|
1972056588 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | CRNA1226 (Arizona) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Plains Regional Medical Center | Clovis, NM | Hospital |
Roosevelt General Hospital | Portales, NM | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Sleepy Plains Anesthesia Llc | 4284960352 | 11 |
Entity Name | Anesthesia Associates Of New Mexico P C |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912900754 PECOS PAC ID: 4385536564 Enrollment ID: O20040325000455 |
Entity Name | Sleepy Plains Anesthesia Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265090344 PECOS PAC ID: 4284960352 Enrollment ID: O20190726001196 |
Mailing Address | Practice Location Address |
---|---|
Mr Jacob Troy Russell, CRNA 823 W Sierra Cir, Payson, AZ 85541-6602 Ph: (480) 209-9285 | Mr Jacob Troy Russell, CRNA 807 S Ponderosa St, Payson, AZ 85541-5542 Ph: (928) 472-1273 |
Loran C Jacobs Jr., CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 807 S Ponderosa St, Payson, AZ 85541 Phone: 602-273-6770 Fax: 602-889-0483 | |
Brooke Mcphee, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 807 S Ponderosa St, Payson, AZ 85541 Phone: 928-471-3222 | |
Guy Caraffa, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 807 S Ponderosa St, Payson, AZ 85541 Phone: 602-273-6770 Fax: 602-889-0489 | |
Kirt Rosenlof, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 807 S Ponderosa St, Payson, AZ 85541 Phone: 602-273-6770 Fax: 602-889-0489 |