| Kent Kosmatka, CRNA | |
|
3333 W Deyoung St, Marion, IL 62959-5884 | |
| (660) 826-5960 | |
| (660) 826-4852 |
| Full Name | Kent Kosmatka |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 3333 W Deyoung St, Marion, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891771770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 209000291 (Illinois) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 26167 (South Carolina) | Primary |
| Entity Name | East Morgan County Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699708743 PECOS PAC ID: 3274443577 Enrollment ID: O20040128000184 |
| Entity Name | East Morgan County Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1699708743 PECOS PAC ID: 3274443577 Enrollment ID: O20110416000032 |
| Mailing Address | Practice Location Address |
|---|---|
| Kent Kosmatka, CRNA Po Box 503256, Saint Louis, MO 63150-0001 Ph: (660) 826-5960 | Kent Kosmatka, CRNA 3333 W Deyoung St, Marion, IL 62959-5884 Ph: (660) 826-5960 |
David I Blue, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3333 W Deyoung St, Marion, IL 62959 Phone: 618-998-7000 | |
Mr. George E Wiggins, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 12266 Deer Run Rd, Marion, IL 62959 Phone: 618-964-1223 | |
Jason L Vallette, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3333 W Deyoung St, Marion, IL 62959 Phone: 660-826-5960 Fax: 660-826-4852 | |
Joseph Specker Iv, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3333 W Deyoung St, Marion, IL 62959 Phone: 228-861-1192 Fax: 618-997-1122 | |
Ms. Karen J. Harbal, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3003 Civic Circle Blvd, Marion, IL 62959 Phone: 618-993-1112 Fax: 618-993-1113 | |
Mr. Christopher R Whitley, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 906 E Gregory Lane, Marion, IL 62959 Phone: 618-993-5327 | |
Gregory Scott Clark, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3333 W Deyoung St, Marion, IL 62959 Phone: 618-998-7000 |