| Gary L Waldron, CRNA | |
|
320 Loretto Rd, Lebanon, KY 40033-1300 | |
| (270) 692-3161 | |
| Not Available |
| Full Name | Gary L Waldron |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 48 Years |
| Location | 320 Loretto Rd, Lebanon, Kentucky |
| 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 |
|---|---|---|---|
| 1417915349 | NPI | - | NPPES |
| 74280710 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 1061368 (Kentucky) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Spring View Hospital | Lebanon, KY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kentucky Anesthesia Group Psc | 4082527890 | 36 |
| Entity Name | Kentucky Anesthesia Group Psc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073608634 PECOS PAC ID: 4082527890 Enrollment ID: O20031107000511 |
| Entity Name | Taylor Regional Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174697601 PECOS PAC ID: 4880616622 Enrollment ID: O20051221000527 |
| Mailing Address | Practice Location Address |
|---|---|
| Gary L Waldron, CRNA 328 Parkwood Dr, Campbellsville, KY 42718-9693 Ph: (270) 789-3766 | Gary L Waldron, CRNA 320 Loretto Rd, Lebanon, KY 40033-1300 Ph: (270) 692-3161 |
Terry Johnson, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 320 Loretto Rd, Lebanon, KY 40033 Phone: 270-692-3161 | |
Deborah L. Doyle, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 320 Loretto Rd, Lebanon, KY 40033 Phone: 270-692-3161 |