| Mr Michael E Tadlock, CRNA | |
|
916 4th Ave. Sw, Pipestone, MN 56164 | |
| (507) 825-5811 | |
| (563) 556-8334 |
| Full Name | Mr Michael E Tadlock |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 21 Years |
| Location | 916 4th Ave. Sw, Pipestone, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609837350 | NPI | - | NPPES |
| 0453241 | Medicaid | IA | |
| 44335300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | D103531 (Iowa) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 223779-0 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Sioux Center Health | Sioux center, IA | Hospital |
| Hawarden Regional Healthcare | Hawarden, IA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sioux Center Health | 9032027495 | 31 |
| Entity Name | Alegent Creighton Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598811069 PECOS PAC ID: 1951210418 Enrollment ID: O20040116000817 |
| Entity Name | Floyd Valley Healthcare |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578625653 PECOS PAC ID: 2769385475 Enrollment ID: O20040129001169 |
| Entity Name | Sioux Center Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669542981 PECOS PAC ID: 9032027495 Enrollment ID: O20040224001315 |
| Entity Name | Hawarden Regional Healthcare |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1841261104 PECOS PAC ID: 0547257990 Enrollment ID: O20081002000123 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Michael E Tadlock, CRNA 916 4th Ave. Sw, Pipestone, MN 56164 Ph: (507) 825-5811 | Mr Michael E Tadlock, CRNA 916 4th Ave. Sw, Pipestone, MN 56164 Ph: (507) 825-5811 |
Shauna Gansen, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 916 4th Ave Sw, Pipestone, MN 56164 Phone: 507-825-5700 Fax: 507-825-6106 |