| Benjamin R Wisenbaker, CRNA | |
|
1541 Kings Hwy, Shreveport, LA 71103-4228 | |
| (318) 626-0000 | |
| (318) 629-4833 |
| Full Name | Benjamin R Wisenbaker |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 12 Years |
| Location | 1541 Kings Hwy, Shreveport, Louisiana |
| 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 |
|---|---|---|---|
| 1023424462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 28217287A (Indiana) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | AP07907 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ochsner Lsu Health Shreveport | Shreveport, LA | Hospital |
| Lutheran Hospital Of Indiana | Fort wayne, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| University Health Shreveport, Llc | 7416207196 | 64 |
| Associated Anesthesiologists Of Fort Wayne Pc | 2264412444 | 101 |
| Entity Name | University Health Shreveport, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619443611 PECOS PAC ID: 7416207196 Enrollment ID: O20181109000875 |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin R Wisenbaker, CRNA 1541 Kings Hwy, Shreveport, LA 71103-4228 Ph: Not Available | Benjamin R Wisenbaker, CRNA 1541 Kings Hwy, Shreveport, LA 71103-4228 Ph: (318) 626-0000 |
Billy B Miller Iii, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118 Phone: 318-212-5000 |
Ms. Lisa Nicole Kellogg, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-675-5000 |
Kurvis Antione Davis, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 367 Carrollton Ave, Shreveport, LA 71105 Phone: 318-573-0604 |
Brian House, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 |
Michael Liles, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-675-5000 |
Kerri Annette Mullone, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 |
Mr. Caleb Phillips, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 8001 Youree Dr, Shreveport, LA 71115 Phone: 318-212-3000 |