Mr Carlan A Wilson Jr, CRNA is a
Nurse Anesthetist, Certified Registered based in Grangeville, Idaho. Mr Carlan A Wilson Jr is licensed to practice in Tennessee (license number 050274) and his current practice location is
607 W Main St, Grangeville, Idaho. He can be reached at his office (for appointments etc.) via phone at
(208) 983-1700.
NPI number for Mr Carlan A Wilson Jr is 1326199092 and his current mailing address is 1001 E Broadway St Stop 2, Pmb 629, Missoula, Montana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1326199092.
Provider's Profile
| Full Name | Mr Carlan A Wilson Jr |
|---|
| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 607 W Main St, Grangeville, Idaho |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1326199092
- Provider Enumeration Date: 01/16/2007
- Last Update Date: 08/04/2011
Medical Identifiers
Medical identifiers for Mr Carlan A Wilson Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1326199092 | NPI | - | NPPES |
| 807009800 | Medicaid | ID | |
| HBLS1 | Other | ID | BLUE CROSS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 050274 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Carlan A Wilson Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Carlan A Wilson Jr, CRNA
1001 E Broadway St Stop 2, Pmb 629,
Missoula, MT 59802-4914
Ph: (239) 285-5858 | Mr Carlan A Wilson Jr, CRNA
607 W Main St,
Grangeville, ID 83530-1345
Ph: (208) 983-1700 |
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