| Mr Samuel White, CRNA | |
|
950 Matthew Dr, Waynesboro, MS 39367-2567 | |
| (601) 735-7101 | |
| (601) 735-7181 |
| Full Name | Mr Samuel White |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 20 Years |
| Location | 950 Matthew Dr, Waynesboro, Mississippi |
| 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 |
|---|---|---|---|
| 1619916434 | NPI | - | NPPES |
| 02672767 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R860585 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Wayne General Hospital | Waynesboro, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wayne General Hospital | 2668457581 | 30 |
| Entity Name | Wayne General Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093930638 PECOS PAC ID: 2668457581 Enrollment ID: O20040623000865 |
| Entity Name | Southern Eye Surgery Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417112277 PECOS PAC ID: 9931278637 Enrollment ID: O20080521000442 |
| Entity Name | South Central Clinics, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801226287 PECOS PAC ID: 4385876655 Enrollment ID: O20140515000834 |
| Entity Name | Southern Eye Surgery And Laser Center, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295244226 PECOS PAC ID: 5496030595 Enrollment ID: O20171114002076 |
| Entity Name | Gac Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386112639 PECOS PAC ID: 4587902663 Enrollment ID: O20190214002975 |
| Entity Name | Sweet Dreams Anesthesia Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427667724 PECOS PAC ID: 1254757685 Enrollment ID: O20200817002170 |
| Entity Name | Soms Anesthesia, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063010189 PECOS PAC ID: 9133531254 Enrollment ID: O20201215000881 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Samuel White, CRNA 950 Matthew Dr, Waynesboro, MS 39367-2590 Ph: (601) 735-7101 | Mr Samuel White, CRNA 950 Matthew Dr, Waynesboro, MS 39367-2567 Ph: (601) 735-7101 |
Marie Dickerson, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 950 Matthew Drive, Waynesboro, MS 39367 Phone: 601-735-7102 Fax: 601-735-7168 |