| Lyon Tige Hazleton, CRNA | |
|
2951 Front St, Suite 3050, Richlands, VA 24641-2055 | |
| (276) 963-8504 | |
| (276) 963-6642 |
| Full Name | Lyon Tige Hazleton |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 21 Years |
| Location | 2951 Front St, Richlands, Virginia |
| 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 |
|---|---|---|---|
| 1194836296 | NPI | - | NPPES |
| 194170 | Other | VA | ANTHEM BCBS |
| 38100005818 | Medicaid | WV | |
| P00318799 | Other | VA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 0024166905 (Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Chi Health St. Francis | Grand island, NE | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Chi Health Clinic Physician Enterprise-anesthesia Llc | 2264794569 | 188 |
| Entity Name | Anesthesia Group Of Grand Island Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346216793 PECOS PAC ID: 1850377110 Enrollment ID: O20040628000198 |
| Entity Name | Chi Health Clinic Physician Enterprise-anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356858419 PECOS PAC ID: 2264794569 Enrollment ID: O20180404000022 |
| Mailing Address | Practice Location Address |
|---|---|
| Lyon Tige Hazleton, CRNA 2951 West Front Street, Suite 3050, Richlands, VA 24641 Ph: (276) 963-8504 | Lyon Tige Hazleton, CRNA 2951 Front St, Suite 3050, Richlands, VA 24641-2055 Ph: (276) 963-8504 |
Roxanne M Decker, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2951 Front St, Suite 3050, Richlands, VA 24641 Phone: 276-963-8504 Fax: 276-963-6642 | |
Monica G Tague, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2949 West Front Street, Richlands, VA 24641 Phone: 276-596-6000 | |
Tiffany Miller, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6801 Governor Gc Peery Hwy, Richlands, VA 24641 Phone: 828-398-5244 |