| Carl G Mallett, CRNA | |
|
1128 Hidden Oak Ln, Lake Charles, LA 70605-7123 | |
| (337) 478-1085 | |
| Not Available |
| Full Name | Carl G Mallett |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1128 Hidden Oak Ln, Lake Charles, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104806124 | NPI | - | NPPES |
| P00140225 | Other | LA | RAILROAD MEDICARE PIN |
| 1115096 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 03828 (Louisiana) | Primary |
| Entity Name | Glen D. Hurlston, M.d., Apmc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306913488 PECOS PAC ID: 3779557541 Enrollment ID: O20040826000006 |
| Mailing Address | Practice Location Address |
|---|---|
| Carl G Mallett, CRNA 1128 Hidden Oak Ln, Lake Charles, LA 70605-7123 Ph: (337) 478-1085 | Carl G Mallett, CRNA 1128 Hidden Oak Ln, Lake Charles, LA 70605-7123 Ph: (337) 478-1085 |
Mr. Leslie B Free, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 4150 Nelson Road, A-4, Lake Charles, LA 70605 Phone: 337-478-2124 Fax: 337-477-7616 | |
Mr. Michael Shelton Adams, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1000 Walters St, Lsu W O Moss Regional Medical Center, Lake Charles, LA 70607 Phone: 337-475-8333 | |
Mr. Robert Geise Phillips, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4150 Nelson Rd, A4 Anesthesia Associates, Lake Charles, LA 70605 Phone: 337-474-6353 Fax: 337-477-7616 | |
Jordan Daughenbaugh, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1900 W Gauthier Rd, Lake Charles, LA 70605 Phone: 337-480-7000 | |
Mr. Randall Dale Biggs, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4150 Nelson Rd, A4 Anesthesia Associates, Lake Charles, LA 70605 Phone: 337-474-6353 Fax: 337-477-7616 | |
Nathaniel J Dennis, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 424 W Mcneese St, Suite L, Lake Charles, LA 70605 Phone: 337-478-0511 Fax: 337-478-5644 |