Tyler Allen Rex, | |
615 N Michigan St, South Bend, IN 46601-1033 | |
(754) 647-1000 | |
Not Available |
Full Name | Tyler Allen Rex |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 615 N Michigan St, South Bend, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1710741871 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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367500000X | Nurse Anesthetist, Certified Registered | 28216557C (Indiana) | Primary |
163WC0200X | Registered Nurse - Critical Care Medicine | 28216557C (Indiana) | Secondary |
Entity Name | Southeast Anesthesiologists, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548210685 PECOS PAC ID: 6800837980 Enrollment ID: O20050518001265 |
Mailing Address | Practice Location Address |
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Tyler Allen Rex, 17875 Bellows Falls Dr N, South Bend, IN 46614-9721 Ph: () - | Tyler Allen Rex, 615 N Michigan St, South Bend, IN 46601-1033 Ph: (754) 647-1000 |
Ms. Jamie Ann Davidson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1536 Crestwood Blvd, South Bend, IN 46635 Phone: 574-360-2619 | |
Alvaro Andres Osorio, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 574-647-1000 | |
Hilda Bartel, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 574-647-1000 | |
Mrs. Julie Anne Addis, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 53830 Generations Dr, South Bend, IN 46635 Phone: 574-271-0893 | |
Janet Vardaman, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 17501 Generations Dr, South Bend, IN 46635 Phone: 574-234-0049 |