| Timothy B Different, CRNA | |
|
2026 S Jackson St, Jacksonville, TX 75766-5822 | |
| (903) 586-5678 | |
| (903) 541-4679 |
| Full Name | Timothy B Different |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 8 Years |
| Location | 2026 S Jackson St, Jacksonville, Texas |
| 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 |
|---|---|---|---|
| 1730643032 | NPI | - | NPPES |
| 769641 | Other | TX | MEDICARE |
| 8KP517 | Other | TX | BCBS |
| 394643601 | Medicaid | TX | |
| P02210751 | Other | TX | MEDICARE RAIL ROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP140173 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Campbell County Health | Gillette, WY | Hospital |
| Ut Health East Texas Jacksonville Hospital | Jacksonville, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Emergenchealth Pllc | 1355606641 | 666 |
| Mother Frances Hospital Jacksonville | 5597751024 | 25 |
| Campbell County Hospital District | 2860392529 | 129 |
| Entity Name | Mother Frances Hospital Jacksonville |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952306672 PECOS PAC ID: 5597751024 Enrollment ID: O20040421001092 |
| Entity Name | Emergenchealth Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467970897 PECOS PAC ID: 1355606641 Enrollment ID: O20180608000439 |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy B Different, CRNA Po Box 847522, Dallas, TX 75284-7522 Ph: (903) 531-5000 | Timothy B Different, CRNA 2026 S Jackson St, Jacksonville, TX 75766-5822 Ph: (903) 586-5678 |
Mr. Martin E Rivera, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2626 S Jackson, Jacksonville, TX 75766 Phone: 903-541-4630 Fax: 903-586-5710 | |
Mr. Barry Lynn Thibodeaux, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1463 Se Loop 456, Jacksonville, TX 75766 Phone: 903-589-1150 | |
David Newsom, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 501 S Ragsdale St, Jacksonville, TX 75766 Phone: 903-677-1000 Fax: 903-677-1694 | |
Mr. Jack David Capps, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2026 S Jackson St, Jacksonville, TX 75766 Phone: 903-541-4500 |