| Blake Lynn Wilson, CRNA | |
|
2001 Cradduck Rd, Ada, OK 74820-9400 | |
| (405) 514-4786 | |
| (405) 758-5582 |
| Full Name | Blake Lynn Wilson |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 14 Years |
| Location | 2001 Cradduck Rd, Ada, Oklahoma |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568712768 | NPI | - | NPPES |
| 200454040A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 89530 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mcalester Regional Health Center | Mcalester, OK | Hospital |
| Mercy Hospital Ada | Ada, OK | Hospital |
| Hillcrest Hospital Henryetta | Henryetta, OK | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Western Oklahoma Anesthesia Consultants Pllc | 4587924865 | 15 |
| Emergenchealth Pllc | 1355606641 | 1037 |
| Sc Anesthesia Llc | 7012382468 | 4 |
| Entity Name | Western Oklahoma Anesthesia Consultants PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881102614 PECOS PAC ID: 4587924865 Enrollment ID: O20180206000663 |
| Entity Name | Anesthesia Management Solutions of Oklahoma PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003375650 PECOS PAC ID: 7618219213 Enrollment ID: O20190501001353 |
| Entity Name | Emergenchealth PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467970897 PECOS PAC ID: 1355606641 Enrollment ID: O20190618003098 |
| Entity Name | SC Anesthesia LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962106013 PECOS PAC ID: 7012382468 Enrollment ID: O20230818001535 |
| Mailing Address | Practice Location Address |
|---|---|
| Blake Lynn Wilson, CRNA 1813 S 14th St, Mcalester, OK 74501-7220 Ph: Not Available | Blake Lynn Wilson, CRNA 2001 Cradduck Rd, Ada, OK 74820-9400 Ph: (405) 514-4786 |
Samuel Douglas Bond, Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 1921 Stonecipher Dr, Ada, OK 74820 Phone: 580-436-3980 |
Johnny J Sacco, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1921 Stonecipher Dr, Ada, OK 74820 Phone: 580-436-3980 Fax: 580-421-6283 |
Tina S Johnston, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1921 Stonecipher Dr, Ada, OK 74820 Phone: 580-436-3980 |
Mr. Mark E. Bucher, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2001 Cradduck Rd, Ada, OK 74820 Phone: 405-514-4786 Fax: 405-758-5354 |
Gerald E Joseph, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 2001 Cradduck Rd, Ada, OK 74820 Phone: 405-514-4786 Fax: 405-758-5354 |
Edward Gradman, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 430 N Monte Vista St, Ada, OK 74820 Phone: 580-332-2323 |
Jerry Gregory, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1921 Stonecipher Blvd, Ada, OK 74820 Phone: 580-421-4570 Fax: 580-421-6258 |