Mr Stanley Richard Gordon, CRNA | |
1301 Belleville Ave, Brewton, AL 36426-1306 | |
(251) 867-8061 | |
Not Available |
Full Name | Mr Stanley Richard Gordon |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 25 Years |
Location | 1301 Belleville Ave, Brewton, Alabama |
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 |
---|---|---|---|
1548295322 | NPI | - | NPPES |
0124687 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 051211 (Alabama) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Western Plains Medical Complex | Dodge city, KS | Hospital |
D W Mcmillan Memorial Hospital | Brewton, AL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
D.w. Mcmillan Memorial Hospital | 3072558378 | 19 |
Clinical Colleagues Ks Pa | 3870921984 | 15 |
Entity Name | D.w. Mcmillan Memorial Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033309125 PECOS PAC ID: 3072558378 Enrollment ID: O20051228000313 |
Entity Name | Marshall Medical Center South |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497269799 PECOS PAC ID: 0648534495 Enrollment ID: O20180503001351 |
Entity Name | Usa Health Anesthesia Billing Services Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629635818 PECOS PAC ID: 1153659123 Enrollment ID: O20190829000530 |
Entity Name | Blue Lake Health Springhill Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194496216 PECOS PAC ID: 2365830007 Enrollment ID: O20211028001840 |
Mailing Address | Practice Location Address |
---|---|
Mr Stanley Richard Gordon, CRNA 5577 Gibson Rd, Theodore, AL 36582-4058 Ph: () - | Mr Stanley Richard Gordon, CRNA 1301 Belleville Ave, Brewton, AL 36426-1306 Ph: (251) 867-8061 |
Mrs. Miriam Mcdaniel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1301 Belleville Ave, Brewton, AL 36426 Phone: 251-809-8383 | |
Mrs. Anita Carnley Hendricks, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1301 Belleville Ave, Brewton, AL 36426 Phone: 251-809-8383 |