| Seung Gin Lee, | |
|
250 Park St, Bowling Green, KY 42101-1760 | |
| (270) 393-1912 | |
| (270) 393-1913 |
| Full Name | Seung Gin Lee |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 250 Park St, Bowling Green, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669847265 | NPI | - | NPPES |
| 7100380560 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 3009982 (Kentucky) | Primary |
| Entity Name | Commonwealth Healthcare Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285858290 PECOS PAC ID: 7719075167 Enrollment ID: O20071212000093 |
| Mailing Address | Practice Location Address |
|---|---|
| Seung Gin Lee, 825 2nd Ave, Suite C6, Bowling Green, KY 42101-1786 Ph: (270) 393-1912 | Seung Gin Lee, 250 Park St, Bowling Green, KY 42101-1760 Ph: (270) 393-1912 |
Christian Michael Kranz, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 250 Park St, Bowling Green, KY 42101 Phone: 270-393-1912 Fax: 270-393-1913 | |
Cody S. Campbell, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 350 Park St, Suite 203b, Bowling Green, KY 42101 Phone: 270-393-1912 Fax: 270-393-1913 | |
Miss Heather G Childress, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 350 Park St, Suite 203b, Bowling Green, KY 42101 Phone: 270-393-1912 Fax: 270-393-1913 | |
Kristin K Bateman, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 250 Park St, Bowling Green, KY 42101 Phone: 270-393-1912 Fax: 270-393-1913 | |
Bruce Scott Weickel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 250 Park St, Bowling Green, KY 42101 Phone: 270-745-1000 Fax: 270-393-1913 | |
Adam Kuzma, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 250 Park St, Bowling Green, KY 42101 Phone: 270-393-1912 Fax: 270-393-1913 | |
Meagan Nicole Moore, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 250 Park St, Bowling Green, KY 42101 Phone: 270-745-1000 |