| Eddie J Wickline, CRNA | |
|
2310 California Rd, Ste A, Elkhart, IN 46514-1228 | |
| (574) 264-0791 | |
| (574) 262-9650 |
| Full Name | Eddie J Wickline |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 38 Years |
| Location | 2310 California Rd, Elkhart, Indiana |
| 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 |
|---|---|---|---|
| 1891805503 | NPI | - | NPPES |
| 200295510 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 28137996A (Indiana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Orthopedic And Sports Medicine Center Of Northern Indiana Inc | 0840260105 | 47 |
| Entity Name | Orthopedic And Sports Medicine Center Of Northern Indiana Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710085253 PECOS PAC ID: 0840260105 Enrollment ID: O20040727000002 |
| Mailing Address | Practice Location Address |
|---|---|
| Eddie J Wickline, CRNA 2310 California Rd, Ste A, Elkhart, IN 46514-1228 Ph: (574) 264-0791 | Eddie J Wickline, CRNA 2310 California Rd, Ste A, Elkhart, IN 46514-1228 Ph: (574) 264-0791 |
Mark Mcpherson, RN Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 600 East Blvd, Elkhart, IN 46514 Phone: 574-523-3193 | |
Ms. Barbara Ann Doherty, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1004 Parkway Ave, Suite B, Elkhart, IN 46516 Phone: 574-522-9922 Fax: 574-522-9926 | |
Lindsay Vasil, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1513 E Jackson Blvd, Elkhart, IN 46516 Phone: 574-523-3193 | |
Denise Christine Brown, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 600 East Blvd, Elkhart, IN 46514 Phone: 574-523-3193 Fax: 574-523-3463 | |
Patty Jean Garlick, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3080 Windsor Ct, Ste B, Elkhart, IN 46514 Phone: 574-266-7817 | |
Sara L Mcnally, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 500 N Nappanee St, Ste 11-b, Elkhart, IN 46514 Phone: 574-522-9922 Fax: 574-522-9926 | |
Breann Marie Kutzer Mcmanus, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 500 N Nappanee St, Suite 11-b, Elkhart, IN 46514 Phone: 574-522-9922 Fax: 574-522-9926 |