Mr Larry Joe Haley, CRNA | |
1 Medical Plaza Pl, Minden, LA 71055-3330 | |
(318) 377-2321 | |
(318) 371-3219 |
Full Name | Mr Larry Joe Haley |
---|---|
Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 1 Medical Plaza Pl, Minden, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114907649 | NPI | - | NPPES |
1901253 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 31805 (Louisiana) | Primary |
Entity Name | Homer Memorial Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609066646 PECOS PAC ID: 1456322692 Enrollment ID: O20040803000291 |
Entity Name | Minden Anesthesia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1710456736 PECOS PAC ID: 1355687757 Enrollment ID: O20190107000024 |
Mailing Address | Practice Location Address |
---|---|
Mr Larry Joe Haley, CRNA 391 Post Oak Ln, Minden, LA 71055-8808 Ph: (318) 371-2725 | Mr Larry Joe Haley, CRNA 1 Medical Plaza Pl, Minden, LA 71055-3330 Ph: (318) 377-2321 |
Philip Jake Killgore, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Plaza Pl, Minden, LA 71055 Phone: 318-377-2321 | |
Mr. George Wayne Byram Jr., CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Plaza Pl, Minden, LA 71055 Phone: 318-377-2321 | |
Gregory David Powell, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 318 Braeburn Glen Dr, Minden, LA 71055 Phone: 318-245-1725 | |
Dean Boelter, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Plaza Pl, Minden, LA 71055 Phone: 318-377-2321 |