| Michael Liles, | |
|
1541 Kings Hwy, Shreveport, LA 71103-4228 | |
| (318) 675-5000 | |
| Not Available |
| Full Name | Michael Liles |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1541 Kings Hwy, Shreveport, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023461977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP08949 (Louisiana) | Primary |
| Entity Name | Arena Anesthesia LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023244779 PECOS PAC ID: 4385795319 Enrollment ID: O20090702000042 |
| Entity Name | Endoscopy Center of Monroe |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1417957796 PECOS PAC ID: 3173666120 Enrollment ID: O20100130000072 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Liles, 1541 Kings Hwy, Shreveport, LA 71103-4228 Ph: (318) 675-5000 | Michael Liles, 1541 Kings Hwy, Shreveport, LA 71103-4228 Ph: (318) 675-5000 |
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 |
Shirley A Kelley, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 8001 Youree Dr, Shreveport, LA 71115 Phone: 318-212-3220 |
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 |
Kerri Annette Mullone, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1541 Kings Hwy, Shreveport, LA 71103 Phone: 318-626-0000 |