| Mark E Wilson, CRNA | |
|
2055 N Main St, Tooele, UT 84074-9819 | |
| (435) 843-3600 | |
| Not Available |
| Full Name | Mark E Wilson |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 22 Years |
| Location | 2055 N Main St, Tooele, Utah |
| 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 |
|---|---|---|---|
| 1881608800 | NPI | - | NPPES |
| 000061222 | Other | UT | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 3110304406 (Utah) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Pinnacle Anesthesia Services Llc | 5890927404 | 4 |
| Entity Name | North Lincoln County Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730132523 PECOS PAC ID: 4789580218 Enrollment ID: O20031208000415 |
| Entity Name | Campbell County Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710098868 PECOS PAC ID: 2860392529 Enrollment ID: O20040206000510 |
| Entity Name | Evanston Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013288836 PECOS PAC ID: 7113900358 Enrollment ID: O20040609001235 |
| Entity Name | Evanston Anesthesia Associates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891979258 PECOS PAC ID: 5991883514 Enrollment ID: O20080423000335 |
| Entity Name | North Lincoln County Hospital District |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1255376406 PECOS PAC ID: 4789580218 Enrollment ID: O20101103000284 |
| Entity Name | Pinnacle Anesthesia Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588092274 PECOS PAC ID: 5890927404 Enrollment ID: O20140415000085 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark E Wilson, CRNA 9895 Eden Crest Rd, South Jordan, UT 84095-3011 Ph: (801) 254-6169 | Mark E Wilson, CRNA 2055 N Main St, Tooele, UT 84074-9819 Ph: (435) 843-3600 |
Matthew A. Smith, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2055 N Main St., Tooele, UT 84074 Phone: 435-843-3600 | |
Robin B. Bradshaw, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2055 N Main St, Tooele, UT 84074 Phone: 435-843-3600 | |
Annette S Proctor, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2055 N Main St, Tooele, UT 84074 Phone: 435-843-3600 | |
Evie Anna Purdom, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2055 N Main St, Tooele, UT 84074 Phone: 435-843-3600 | |
Christopher David Smith, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2055 N Main St, Tooele, UT 84074 Phone: 435-843-8543 | |
Mr. Kyle H Jones, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2055 N Main St, Tooele, UT 84074 Phone: 435-843-3600 |