| Mr Jesse Lynn Ryan, CRNA | |
|
521 Hill Street, Sw, Thomson, GA 30824-2118 | |
| (706) 597-5239 | |
| (706) 597-5141 |
| Full Name | Mr Jesse Lynn Ryan |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 521 Hill Street, Sw, Thomson, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376603290 | NPI | - | NPPES |
| 000519384E | Medicaid | GA | |
| 43ZCBFH | Other | GA | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R074053 (Georgia) | Primary |
| Entity Name | Fulton Dekalb Hospital Authority |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992799050 PECOS PAC ID: 6406757590 Enrollment ID: O20040614000100 |
| Entity Name | Anesthesia Consultants Of Augusta Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881877793 PECOS PAC ID: 6204905763 Enrollment ID: O20080523000204 |
| Entity Name | Ams Southeast Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487107157 PECOS PAC ID: 3870880792 Enrollment ID: O20160921000551 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jesse Lynn Ryan, CRNA 4282 Deerwood Ln, Evans, GA 30809-4224 Ph: (706) 597-5239 | Mr Jesse Lynn Ryan, CRNA 521 Hill Street, Sw, Thomson, GA 30824-2118 Ph: (706) 597-5239 |
Mr. Lawrence R. Klein, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3028 Surrey Rd, Thomson, GA 30824 Phone: 706-595-1183 |