| Edward Lee Phelps, CRNA | |
|
1203 Bluff Rd, Coldwater, MS 38618-6719 | |
| (662) 562-7654 | |
| Not Available |
| Full Name | Edward Lee Phelps |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 18 Years |
| Location | 1203 Bluff Rd, Coldwater, Mississippi |
| 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 |
|---|---|---|---|
| 1205097409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R862681 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Baptist Memorial Hospital Desoto | Southaven, MS | Hospital |
| Regional One Health | Memphis, TN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| American Anesthesiology Of Mississippi Llc | 4789057878 | 25 |
| Midsouth Speciality Anesthesia Services Llc | 6103293667 | 22 |
| Willow Anesthesia Services, Llc | 9234279183 | 34 |
| Ut Regional One Physicians Inc | 5698993418 | 298 |
| Midsouth Speciality Anesthesia Services Llc | 6103293667 | 22 |
| 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: O20091228000308 |
| Entity Name | Midsouth Speciality Anesthesia Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245956440 PECOS PAC ID: 6103293667 Enrollment ID: O20221114002027 |
| Entity Name | American Anesthesiology Of Mississippi Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023723558 PECOS PAC ID: 4789057878 Enrollment ID: O20230311000163 |
| Mailing Address | Practice Location Address |
|---|---|
| Edward Lee Phelps, CRNA 1203 Bluff Rd, Coldwater, MS 38618-6719 Ph: (662) 562-7654 | Edward Lee Phelps, CRNA 1203 Bluff Rd, Coldwater, MS 38618-6719 Ph: (662) 562-7654 |
Patricia Dianne Hudson, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 271 Golden Rd, Coldwater, MS 38618 Phone: 662-292-1301 |