| Brock S Clough, APRN, CRNA | |
|
1101 9th St N, Virginia, MN 55792-2329 | |
| (218) 741-0150 | |
| Not Available |
| Full Name | Brock S Clough |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 6 Years |
| Location | 1101 9th St N, Virginia, Minnesota |
| 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 |
|---|---|---|---|
| 1811534118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 2432 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fairview Northland Regional Hospital | Princeton, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Duluth Clinic Ltd | 2567374283 | 957 |
| Central Minnesota Anesthesia Providers, Pa | 7315848876 | 10 |
| Entity Name | The Duluth Clinic Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902563638 PECOS PAC ID: 2567374283 Enrollment ID: O20031103000229 |
| Entity Name | Central Minnesota Anesthesia Providers, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881689974 PECOS PAC ID: 7315848876 Enrollment ID: O20040116000877 |
| Entity Name | Anesthesiology, P.a. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013960798 PECOS PAC ID: 9335033034 Enrollment ID: O20040212000459 |
| Mailing Address | Practice Location Address |
|---|---|
| Brock S Clough, APRN, CRNA 1702 University Dr S, Fargo, ND 58103-4940 Ph: () - | Brock S Clough, APRN, CRNA 1101 9th St N, Virginia, MN 55792-2329 Ph: (218) 741-0150 |
Lance Manty, APRN, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1101 9th St N, Essentia Health Virginia Clinic, Virginia, MN 55792 Phone: 218-741-0150 | |
Mr. Erik Michael Watson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 901 9th St N, Virginia, MN 55792 Phone: 218-749-9457 Fax: 218-749-9427 | |
Lynette Corrine Klos, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 901 9th St N, Virginia, MN 55792 Phone: 218-741-3340 | |
Gary Wayne Tuthill, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 901 9th St N, Virginia, MN 55792 Phone: 218-741-3340 | |
Joseph F Carter, APRN,CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1101 9th St N, Virginia, MN 55792 Phone: 218-741-0150 | |
Theresa Marie Duffy, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 901 9th St N, Virginia, MN 55792 Phone: 218-749-9457 | |
Robert Jon Hill, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 901 9th St N, Essentia Health Virginia, Virginia, MN 55792 Phone: 218-741-3340 |