Crawford Reed Wallace Jr, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Carriere, Mississippi. He went to University Of Arkansas College Of Medicine and graduated in 2013 and has 13 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Deep South Anesthesia, Inc and his current practice location is
32 Clear Sky Dr, Carriere, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(601) 337-0700.
Crawford Reed Wallace Jr is licensed to practice in Mississippi (license number R881469) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1598108896.
Provider's Profile
| Full Name | Crawford Reed Wallace Jr |
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| Gender | Male |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 13 Years |
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| Location | 32 Clear Sky Dr, Carriere, Mississippi |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Crawford Reed Wallace Jr attended and graduated from University Of Arkansas College Of Medicine in 2013
NPI Data:
- NPI Number: 1598108896
- Provider Enumeration Date: 04/17/2013
- Last Update Date: 02/22/2016
Medicare PECOS Information:
- PECOS PAC ID: 8123269727
- Enrollment ID: I20141014001346
Medical Identifiers
Medical identifiers for Crawford Reed Wallace Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1598108896 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 163W00000X | Registered Nurse | R881469 (Mississippi) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | R881469 (Mississippi) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Deep South Anesthesia, Inc | 4284897612 | 5 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Crawford Reed Wallace Jr allows following entities to bill medicare on his behalf.
| Entity Name | Delta Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1790701134 PECOS PAC ID: 6608775531 Enrollment ID: O20040108000636 |
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| Entity Name | Deep South Anesthesia, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164738712 PECOS PAC ID: 4284897612 Enrollment ID: O20120523000317 |
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| Entity Name | Delta Health System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1447818026 PECOS PAC ID: 9830593821 Enrollment ID: O20210812003936 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Crawford Reed Wallace Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Crawford Reed Wallace Jr, CRNA 32 Clear Sky Dr, Carriere, MS 39426-7818 Ph: (601) 337-0700 | Crawford Reed Wallace Jr, CRNA 32 Clear Sky Dr, Carriere, MS 39426-7818 Ph: (601) 337-0700 |
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