| Dalton James Porche, | |
|
315 Hospital Dr, Madison, TN 37115-5030 | |
| (615) 868-6503 | |
| Not Available |
| Full Name | Dalton James Porche |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 5 Years |
| Location | 315 Hospital Dr, Madison, Tennessee |
| 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 |
|---|---|---|---|
| 1174292445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | RN258274 (Georgia) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 136268 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Southeastern Regional Medical Center | Newnan, GA | Hospital |
| Wellstar West Georgia Medical Center | Lagrange, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sentry Anesthesia Management, Llc | 9436372323 | 203 |
| Entity Name | Sentry Anesthesia Management, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134544794 PECOS PAC ID: 9436372323 Enrollment ID: O20140521002571 |
| Mailing Address | Practice Location Address |
|---|---|
| Dalton James Porche, 865 Bellevue Rd Apt F2, Nashville, TN 37221-2715 Ph: (770) 549-1002 | Dalton James Porche, 315 Hospital Dr, Madison, TN 37115-5030 Ph: (615) 868-6503 |
Steven L. Beaty, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1994 Gallatin Pike N, Suite 202, Madison, TN 37115 Phone: 615-851-0001 Fax: 615-851-0021 | |
Henry Garcia, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 154 Cude Ln, Madison, TN 37115 Phone: 615-865-6268 Fax: 615-868-7378 | |
Alexa Roche, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 315 Hospital Dr, Madison, TN 37115 Phone: 615-868-6503 | |
William Fraser, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 154 Cude Ln, Madison, TN 37115 Phone: 615-865-6268 Fax: 615-868-7378 | |
Cecil Fuller Ii, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 315 Hospital Dr, Madison, TN 37115 Phone: 615-868-6503 | |
Troy Sasser, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 154 Cude Ln, Madison, TN 37115 Phone: 615-865-6268 Fax: 615-868-7378 | |
Thomas Coghlan, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 154 Cude Ln, Madison, TN 37115 Phone: 615-865-6268 Fax: 615-868-7378 |