| Daniel Tyler Harris, CRNA | |
|
1 Meadows Pkwy, Vidalia, GA 30474-8759 | |
| (912) 538-5537 | |
| (912) 538-5228 |
| Full Name | Daniel Tyler Harris |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 11 Years |
| Location | 1 Meadows Pkwy, Vidalia, Georgia |
| 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 |
|---|---|---|---|
| 1730572850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN206834 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Meadows Regional Medical Center | Vidalia, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Se Georgia Anesthesia, Llc | 8426466137 | 106 |
| Entity Name | American Anesthesiology Associates Of Georgia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528068673 PECOS PAC ID: 7618934779 Enrollment ID: O20041210000442 |
| Entity Name | Se Georgia Anesthesia, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518542919 PECOS PAC ID: 8426466137 Enrollment ID: O20210419001856 |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel Tyler Harris, CRNA Po Box 1303, Vidalia, GA 30475-1303 Ph: (912) 538-5537 | Daniel Tyler Harris, CRNA 1 Meadows Pkwy, Vidalia, GA 30474-8759 Ph: (912) 538-5537 |
Shannon Lacey Staten, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Meadows Pkwy, Vidalia, GA 30474 Phone: 912-538-5537 | |
Brandon Reeves Blount, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Meadows Pkwy, Vidalia, GA 30474 Phone: 535-912-5894 | |
Damon Keith Jessup, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Meadows Pkwy, Vidalia, GA 30474 Phone: 912-538-5537 Fax: 912-538-5228 | |
Timothy Roose, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: One Meadows Pkwy, Vidalia, GA 30474 Phone: 912-538-5359 Fax: 912-538-5228 | |
Ann Marie Chalker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Meadows Pkwy, Vidalia, GA 30474 Phone: 912-538-5359 Fax: 912-538-5228 |