| Kenneth L Boswell, CRNA | |
|
990 Oak Ridge Tpke, Oak Ridge, TN 37830-6976 | |
| (865) 481-1112 | |
| (770) 237-1124 |
| Full Name | Kenneth L Boswell |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 30 Years |
| Location | 990 Oak Ridge Tpke, Oak Ridge, Tennessee |
| 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 |
|---|---|---|---|
| 1053380568 | NPI | - | NPPES |
| 152347 | Other | TN | NURSING LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 152347 (Tennessee) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mississippi Baptist Medical Center | Jackson, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Perioperative Services Of Mississippi, Llc | 8921365255 | 80 |
| Entity Name | Medical Foundation Of Central Mississippi Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992774814 PECOS PAC ID: 1153216411 Enrollment ID: O20040217000380 |
| Entity Name | Jackson Anesthesia Associates Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780737577 PECOS PAC ID: 3870585904 Enrollment ID: O20040331000285 |
| Entity Name | Perioperative Services Of Mississippi, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881123123 PECOS PAC ID: 8921365255 Enrollment ID: O20171122000010 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth L Boswell, CRNA Po Box 5059, Oak Ridge, TN 37831-5059 Ph: (800) 611-6713 | Kenneth L Boswell, CRNA 990 Oak Ridge Tpke, Oak Ridge, TN 37830-6976 Ph: (865) 481-1112 |
Harber Ingle, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 990 Oak Ridge Tpke, Oak Ridge, TN 37830 Phone: 800-611-6713 | |
Lacey King, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 990 Oak Ridge Tpke, Oak Ridge, TN 37830 Phone: 865-835-3560 | |
Doris Lewis, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 990 Oak Ridge Tpke, Anesthesia Dept, Oak Ridge, TN 37830 Phone: 865-481-1112 Fax: 770-237-1124 | |
Micah Shea Clark, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 990 Oak Ridge Tpke, Oak Ridge, TN 37830 Phone: 931-858-6303 Fax: 931-858-6305 | |
Roger B Lee, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 990 Oak Ridge Tpke, Anesthesia Dept, Oak Ridge, TN 37830 Phone: 800-611-6713 Fax: 770-237-1124 | |
Christina Bonner, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 990 Oak Ridge Tpke, Oak Ridge, TN 37830 Phone: 865-481-1112 Fax: 770-237-1124 |