| Charles Cory Hallacy, | |
|
3066 N Kentucky St, Iola, KS 66749-1951 | |
| (620) 365-1000 | |
| Not Available |
| Full Name | Charles Cory Hallacy |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 3066 N Kentucky St, Iola, Kansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295211704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 557616 (Kansas) | Primary |
| Entity Name | Labette County Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336133362 PECOS PAC ID: 5496664369 Enrollment ID: O20031112000344 |
| Entity Name | Saint Lukes Hospital Of Garnett Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619901725 PECOS PAC ID: 8729071691 Enrollment ID: O20040406001183 |
| Entity Name | Freeman Surgical Center Of Pittsburg, Llc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1881089076 PECOS PAC ID: 6608186895 Enrollment ID: O20151029002046 |
| Entity Name | Saint Lukes Hospital Of Allen County Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639185457 PECOS PAC ID: 5496178691 Enrollment ID: O20200805001823 |
| Entity Name | Baxley Anesthetics Of Kansas |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508562059 PECOS PAC ID: 1951776764 Enrollment ID: O20230410001345 |
| Entity Name | Mercy Clinic Pittsburg Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912751884 PECOS PAC ID: 7618418088 Enrollment ID: O20240925002855 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Cory Hallacy, 303 S Pine St, Arma, KS 66712-4008 Ph: () - | Charles Cory Hallacy, 3066 N Kentucky St, Iola, KS 66749-1951 Ph: (620) 365-1000 |
David Willis Jordan, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 101 South First Street, Iola, KS 66749 Phone: 620-365-1000 |