| Robert Dustin Bulloch, CRNA | |
|
1000 N Main St, Richfield, UT 84701-2061 | |
| (435) 893-4100 | |
| Not Available |
| Full Name | Robert Dustin Bulloch |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 11 Years |
| Location | 1000 N Main St, Richfield, Utah |
| 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 |
|---|---|---|---|
| 1982000451 | NPI | - | NPPES |
| 2097438 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP60840896 (Washington) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 6573583-4406 (Utah) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Premier Anesthesia Of Richland A Division Of Premier Anesthesia, Llc | 4880699172 | 66 |
| Medstream Anesthesia Pllc | 7416198049 | 515 |
| Entity Name | Grant County Public Hospital District 1 |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619086766 PECOS PAC ID: 9931095692 Enrollment ID: O20040227000602 |
| Entity Name | Premier Anesthesia Of Richland A Division Of Premier Anesthesia, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013940253 PECOS PAC ID: 4880699172 Enrollment ID: O20060920000047 |
| Entity Name | Medstream Anesthesia Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649616160 PECOS PAC ID: 7416198049 Enrollment ID: O20211021002476 |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Dustin Bulloch, CRNA 1000 N Main St, Richfield, UT 84701-2061 Ph: (435) 893-4100 | Robert Dustin Bulloch, CRNA 1000 N Main St, Richfield, UT 84701-2061 Ph: (435) 893-4100 |
Elosia Furbee, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1000 N Main St, Richfield, UT 84701 Phone: 435-893-4100 | |
Rex K Belnap, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1000 N Main St, Richfield, UT 84701 Phone: 435-893-0305 Fax: 435-893-0369 | |
Thomas J. Tavenner, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1000 N Main St, Richfield, UT 84701 Phone: 435-893-4100 |