| Charles E Dalton Jr, CRNA | |
|
830 South Gloster, Tupelo, MS 38801 | |
| (662) 377-4394 | |
| (662) 377-7045 |
| Full Name | Charles E Dalton Jr |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 23 Years |
| Location | 830 South Gloster, Tupelo, Mississippi |
| 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 |
|---|---|---|---|
| 1720004914 | NPI | - | NPPES |
| 009936468 | Medicaid | AL | |
| 09473296 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R860109 (Mississippi) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Trident Anesthesia Llc | 6901028315 | 4 |
| Entity Name | North Mississippi Medical Center, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972608347 PECOS PAC ID: 9931010600 Enrollment ID: O20040413000541 |
| Entity Name | Tupelo Anesthesia Group, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558390443 PECOS PAC ID: 4587566344 Enrollment ID: O20040508000197 |
| Entity Name | Nurse Anesthesia Providers Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275749228 PECOS PAC ID: 6507871837 Enrollment ID: O20060208000283 |
| Entity Name | Trident Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053713123 PECOS PAC ID: 6901028315 Enrollment ID: O20141119000230 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles E Dalton Jr, CRNA Po Box 3294, Tupelo, MS 38803-3294 Ph: (662) 377-4394 | Charles E Dalton Jr, CRNA 830 South Gloster, Tupelo, MS 38801 Ph: (662) 377-4394 |
Lauren Elizabeth Abel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 830 S Gloster St, Tupelo, MS 38801 Phone: 662-377-4394 Fax: 662-377-7045 | |
Sarah Cotton Ashmore, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 830 South Gloster, Tupelo, MS 38801 Phone: 662-377-4394 Fax: 662-377-7045 | |
Mr. Bradley W Jones, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 830 S Gloster St, Tupelo, MS 38801 Phone: 662-377-4394 Fax: 662-377-7045 | |
Lauren H. Cook, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 830 S Gloster St, Tupelo, MS 38801 Phone: 662-377-4394 Fax: 662-377-7045 | |
Shannon D Barber, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 830 South Gloster, Tupelo, MS 38801 Phone: 662-377-4394 Fax: 662-377-7045 | |
Jennifer M Little, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 830 South Gloster, Tupelo, MS 38801 Phone: 662-377-4394 Fax: 662-377-7045 | |
Donald R Carter, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 830 South Gloster, Tupelo, MS 38801 Phone: 662-377-4394 Fax: 662-377-7045 |