| Mr Cecil Timothy Jackson, CRNA | |
|
90 Highway 91 South, C/o Barrett Hospital & Healthcare, Dillon, MT 59725-3597 | |
| (406) 683-3000 | |
| (406) 683-3011 |
| Full Name | Mr Cecil Timothy Jackson |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 90 Highway 91 South, Dillon, Montana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851330666 | NPI | - | NPPES |
| 29774 | Other | MT | STATE LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 29774 (Montana) | Primary |
| Entity Name | Steele Memorial Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851403265 PECOS PAC ID: 9436131265 Enrollment ID: O20040604000056 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Cecil Timothy Jackson, CRNA 203 S Daisy St, Salmon, ID 83467-4709 Ph: (208) 756-2429 | Mr Cecil Timothy Jackson, CRNA 90 Highway 91 South, C/o Barrett Hospital & Healthcare, Dillon, MT 59725-3597 Ph: (406) 683-3000 |
Dennis B. Hatfield, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 90 Highway 91 South, Dillon, MT 59725 Phone: 406-683-2323 | |
Kathleen S Maunu, RN, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 600 Mt Highway 91 S, Dillon, MT 59725 Phone: 406-683-3000 Fax: 406-683-3027 | |
Gordon H. Lucas, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 90 Highway 91 South, Dillon, MT 59725 Phone: 406-683-3000 | |
Kenny Joe Wallen, D.N.P. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 600 State Hwy 91 S, Dillon, MT 59725 Phone: 406-683-3000 |