| David R Whitehead, CRNA | |
|
105 Wall St, Poteau, OK 74953-4433 | |
| (918) 635-3566 | |
| (918) 635-3309 |
| Full Name | David R Whitehead |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 15 Years |
| Location | 105 Wall St, Poteau, Oklahoma |
| 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 |
|---|---|---|---|
| 1982992996 | NPI | - | NPPES |
| 9957742 | Other | MS | AETNA |
| P01009724 | Other | MS | RAILROAD MEDICARE |
| 200499820B | Medicaid | OK | |
| 08277891 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R871679 (Mississippi) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | R113988 (Oklahoma) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ouachita County Medical Center | Camden, AR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Willow Anesthesia Services, Llc | 9234279183 | 34 |
| Entity Name | Willow Anesthesia Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205169521 PECOS PAC ID: 9234279183 Enrollment ID: O20100407000363 |
| Entity Name | Dream Team Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215629464 PECOS PAC ID: 8820457021 Enrollment ID: O20230706002251 |
| Entity Name | Protection Anesthesia Services Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457001109 PECOS PAC ID: 4486014834 Enrollment ID: O20230717001616 |
| Mailing Address | Practice Location Address |
|---|---|
| David R Whitehead, CRNA Po Box 1148, Poteau, OK 74953-1148 Ph: (918) 635-3566 | David R Whitehead, CRNA 105 Wall St, Poteau, OK 74953-4433 Ph: (918) 635-3566 |
Mr. Philip None Streetman, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 500 Polk Creek St, Poteau, OK 74953 Phone: 918-649-3426 Fax: 918-649-3426 |