| Molly Black, | |
|
1585 3rd St, Fort Polk, LA 71459-5102 | |
| (210) 862-9692 | |
| Not Available |
| Full Name | Molly Black |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1585 3rd St, Fort Polk, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114529674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 10041796 (Oregon) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 971137 (Texas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Molly Black, 43 Bassett St, Fort Bragg, NC 28307-2032 Ph: () - | Molly Black, 1585 3rd St, Fort Polk, LA 71459-5102 Ph: (210) 862-9692 |
Anthony Wendell Marcukaitis, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1585 Third St, Fort Polk, LA 71459 Phone: 337-531-3517 | |
Laura Payton, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1585 3rd St, Fort Polk, LA 71459 Phone: 337-718-2889 | |
Mr. Douglas Anthony Phillips, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1585 3rd St, Bayne Jones Army Community Hospital, Fort Polk, LA 71459 Phone: 337-531-3344 | |
Douglas Tortella, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1585 3rd St, Fort Polk, LA 71459 Phone: 337-531-3011 | |
Michael David Smithers, CRNA, DNAP Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: Bayne-jones Army Community Hospital, 1585 Third St, Fort Polk, LA 71459 Phone: 808-321-2748 | |
Mr. Raymond James Devlin Iii, MSN, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 16513 Howard St, Apt D, Fort Polk, LA 71459 Phone: 337-537-5375 |