Mr Walter Jesse Trudo, CRNA | |
3100 Channing Way, Idaho Falls, ID 83404-7533 | |
(479) 659-2746 | |
Not Available |
Full Name | Mr Walter Jesse Trudo |
---|---|
Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 3100 Channing Way, Idaho Falls, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841243474 | NPI | - | NPPES |
4704251198 | Other | MI | ANESTHESIOLOGY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | R 0090514 (Oklahoma) | Primary |
Entity Name | Taylor Surgery Center, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740738897 PECOS PAC ID: 2163601675 Enrollment ID: O20110128000551 |
Mailing Address | Practice Location Address |
---|---|
Mr Walter Jesse Trudo, CRNA 343 Sunterra Dr, Idaho Falls, ID 83404-5089 Ph: (479) 659-2746 | Mr Walter Jesse Trudo, CRNA 3100 Channing Way, Idaho Falls, ID 83404-7533 Ph: (479) 659-2746 |
Reed D Loertscher, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6285 | |
Mr. David Joseph Swope, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2375 E Sunnyside Rd, Suite B, Idaho Falls, ID 83404 Phone: 208-421-1159 | |
Carlene M Canfield, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1601 E 17th St, Idaho Falls, ID 83404 Phone: 208-525-2090 Fax: 208-525-2662 | |
Douglas Jex, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6269 | |
Mr. Bryan Todd Merkley, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2325 Coronado St, Idaho Falls, ID 83404 Phone: 208-557-2700 | |
Dr. Scott Havard, DNP, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2325 Coronado St, Idaho Falls, ID 83404 Phone: 207-745-4081 | |
Brent Michael Sutherland, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2532 Coronado, Idaho Falls, ID 83404 Phone: 208-557-2700 |