Mr Kevin L Dickerson, CRNA | |
2900 1st Ave, Huntington, WV 25702-1241 | |
(304) 526-1031 | |
Not Available |
Full Name | Mr Kevin L Dickerson |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 18 Years |
Location | 2900 1st Ave, Huntington, West Virginia |
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 |
---|---|---|---|
1083786180 | NPI | - | NPPES |
001721151 | Other | WV | WV BLUE CROSS PROVIDER # |
3810001843 | Medicaid | WV | |
550696369-00 | Other | WV | WV WORKERS COMP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 54468 (West Virginia) | Primary |
367500000X | Nurse Anesthetist, Certified Registered | 08320 (Ohio) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
St Mary's Medical Center | Huntington, WV | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
River Cities Anesthesia Pllc | 6002707015 | 58 |
River Cities Anesthesia Pllc | 6002707015 | 58 |
Entity Name | River Cities Anesthesia Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699845164 PECOS PAC ID: 6002707015 Enrollment ID: O20040322000089 |
Mailing Address | Practice Location Address |
---|---|
Mr Kevin L Dickerson, CRNA Po Box 515, Barboursville, WV 25504-0515 Ph: (304) 736-6126 | Mr Kevin L Dickerson, CRNA 2900 1st Ave, Huntington, WV 25702-1241 Ph: (304) 526-1031 |
Lora Brown, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1540 Spring Valley Dr, Huntington, WV 25704 Phone: 304-429-6741 | |
Cindy L Childers, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1340 Hal Greer Blvd, Huntington, WV 25701 Phone: 205-322-1808 Fax: 205-322-1851 | |
Mr. William D Howell, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2900 First Avenue, Huntington, WV 25702 Phone: 304-526-1031 | |
Lisa R Lee, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1340 Hal Greer Blvd, Huntington, WV 25701 Phone: 304-399-2960 | |
Mrs. Carol Elaine Porter, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2900 First Ave, Suite 6019, Huntington, WV 25702 Phone: 304-399-0137 Fax: 304-399-0138 | |
Jamie H Vance, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2900 First Avenue, Huntington, WV 25702 Phone: 304-526-1234 | |
Thressa Pemberton, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1340 Hal Greer Blvd, Huntington, WV 25701 Phone: 304-526-2000 |