| James Russell Tolbert, CRNA | |
|
3217 Mabel St, Shreveport, LA 71103-4022 | |
| (318) 631-9121 | |
| (318) 638-6018 |
| Full Name | James Russell Tolbert |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 23 Years |
| Location | 3217 Mabel St, Shreveport, Louisiana |
| 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 |
|---|---|---|---|
| 1609856376 | NPI | - | NPPES |
| 1193178 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP04404 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Willis Knighton Medical Center, Inc | Shreveport, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Willis Knighton Medical Center Inc Crna Group | 1759358674 | 90 |
| Youngs Professional Services Llc | 2163524992 | 218 |
| Entity Name | Willis Knighton Medical Center Inc Crna Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174546097 PECOS PAC ID: 1759358674 Enrollment ID: O20040910001124 |
| Entity Name | Shreveport Sedation Associates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770083164 PECOS PAC ID: 3173886736 Enrollment ID: O20180412000333 |
| Entity Name | Anesthesia Dynamics Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073001012 PECOS PAC ID: 3779832530 Enrollment ID: O20201020002548 |
| Mailing Address | Practice Location Address |
|---|---|
| James Russell Tolbert, CRNA 3217 Mabel St, Shreveport, LA 71103-4022 Ph: (318) 631-9121 | James Russell Tolbert, CRNA 3217 Mabel St, Shreveport, LA 71103-4022 Ph: (318) 631-9121 |
Billy B Miller Iii, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118 Phone: 318-212-5000 | |
Ms. Lisa Nicole Kellogg, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-675-5000 | |
Kurvis Antione Davis, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 367 Carrollton Ave, Shreveport, LA 71105 Phone: 318-573-0604 | |
Brian House, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 | |
Benjamin R. Wisenbaker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 Fax: 318-629-4833 | |
Michael Liles, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-675-5000 | |
Kerri Annette Mullone, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 |