| Brent H Suddeth, CRNA | |
|
201 Hospital Rd, Anesthesia Dept, Canton, GA 30114-2408 | |
| (404) 851-6500 | |
| (770) 237-1124 |
| Full Name | Brent H Suddeth |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 201 Hospital Rd, Canton, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063480457 | NPI | - | NPPES |
| RN149420 | Other | GA | GA NURSING LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN149420 (Georgia) | Primary |
| Entity Name | Gastrointestinal Specialist Of Georgia |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801975339 PECOS PAC ID: 9335032820 Enrollment ID: O20040206000897 |
| Entity Name | Progressive Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215225560 PECOS PAC ID: 7618148263 Enrollment ID: O20110912000776 |
| Mailing Address | Practice Location Address |
|---|---|
| Brent H Suddeth, CRNA Po Box 465686, Lawrenceville, GA 30042-5686 Ph: (770) 237-1561 | Brent H Suddeth, CRNA 201 Hospital Rd, Anesthesia Dept, Canton, GA 30114-2408 Ph: (404) 851-6500 |
Morgan Maeger, Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 1032 Forest Creek Dr, Canton, GA 30115 Phone: 770-367-3955 | |
Khushbu Modi, Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 276 Harmony Lake Dr, Canton, GA 30115 Phone: 404-488-5590 | |
Carla D Porche, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 201 Hospital Rd, Anesthesia Dept, Canton, GA 30114 Phone: 404-851-6500 Fax: 770-237-1124 | |
James Michael Rutherford, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 201 Hospital Rd, Canton, GA 30114 Phone: 770-720-5100 Fax: 770-720-4508 | |
Marni Elizabeth Daniel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 201 Hospital Rd, Canton, GA 30114 Phone: 770-720-5100 Fax: 770-720-4508 | |
Kimberle J Hickey, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 201 Hospital Rd, Anesthesia Department, Canton, GA 30114 Phone: 404-851-6500 Fax: 770-237-1124 |