Walter P Theriot (NPI# 1356346316, PAC ID# 5698960268) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1356346316 |
| PAC ID by PECOS | 5698960268 |
| Professional Enrollment ID | I20101109000301 |
| Full Name | Walter P Theriot |
| Organization Legal Name | JEFFERSON REGIONAL ANESTHESIA LLC |
| Address |
1600 W 40th Ave Pine Bluff AR 71603-6301 |
| Phone Number | 8705417370 |
| Gender | M |
| Graduation Year | 1988 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 6204171846 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 040071 | JEFFERSON REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1600 W 40th Ave, Pine Bluff, AR 71603-6301 | 8705417370 | JEFFERSON REGIONAL ANESTHESIA LLC |
| Organization Legal Name | JEFFERSON REGIONAL ANESTHESIA LLC |
| Physicians | 17 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Fawad H Walajahi | Anesthesiology | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Jonathan M Loetscher | Certified Registered Nurse Anesthetist (crna) | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Patrick R. Flynn | Certified Registered Nurse Anesthetist (crna) | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Clay W Young | Certified Registered Nurse Anesthetist (crna) | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Nicholas Chad Holloway | Certified Registered Nurse Anesthetist (crna) | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Lori E Cole | Certified Registered Nurse Anesthetist (crna) | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| John W Williams Iii | Certified Registered Nurse Anesthetist (crna) | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Delana Potter | Certified Registered Nurse Anesthetist (crna) | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Shelby A Turner | Certified Registered Nurse Anesthetist (crna) | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Scotty L Reddin | Certified Registered Nurse Anesthetist (crna) | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Street Address |
1600 W 40TH AVE |
| City | PINE BLUFF |
| State | AR |
| Zip | 71603-6301 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charles Edward Gaines Jr. | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Arkansas Professional Corporation | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Fawad H Walajahi | Anesthesiology | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Chelsi Musick | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Arkansas Professional Corporation | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Jonathan M Loetscher | Certified Registered Nurse Anesthetist (crna) | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Naznin Tallat Jamal | Internal Medicine | Southeast Arkansas Hospitalists LLP | 1600 W 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603-6301 |
| Shellia Anne Kornegay | Nurse Practitioner | Southeast Arkansas Emergency Physicians LLP | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Brandie J Cockrell | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Arkansas Professional Corporation | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Nnamdi K Ifediora | Internal Medicine | Southeast Arkansas Hospitalists LLP | 1600 W 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603-6301 |
| Patrick R. Flynn | Certified Registered Nurse Anesthetist (crna) | Jefferson Regional Anesthesia LLC | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Kayhan Bangash | Family Medicine | Southeast Arkansas Emergency Physicians LLP | 1600 W 40th Ave, Pine Bluff, AR 71603-6301 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rodolfo E Lim | Diagnostic Radiology | Pine Bluff Radiologists, Ltd | 1801 W 40th St, Pine Bluff, AR 71603 |
| Syed A Samad | Gastroenterology | Digestive Care P A | 4800 Hazel St, Pine Bluff, AR 71603-2797 |
| Cyrus Tamboli | Gastroenterology | Digestive Care P A | 4800 Hazel St, Pine Bluff, AR 71603-2797 |
| Denise Jarrett | Clinical Social Worker | Southeast Arkansas Behavioral Healthcare System Inc | 2500 Rike Dr, Pine Bluff, AR 71603-3937 |
| Bessie Lancelin | Clinical Social Worker | Southeast Arkansas Behavioral Healthcare System Inc | 2500 Rike Dr, Pine Bluff, AR 71603-3937 |
| Abeer Washington | Psychiatry | Southeast Arkansas Behavioral Healthcare System Inc | 2500 Rike Dr, Pine Bluff, AR 71603-3937 |
| Diane C. Boyd | Nurse Practitioner | Southeast Arkansas Behavioral Healthcare System Inc | 2500 Rike Dr, Pine Bluff, AR 71603-3937 |
| Joyce A Walker | Clinical Social Worker | Southeast Arkansas Behavioral Healthcare System Inc | 2500 Rike Dr, Pine Bluff, AR 71603-3937 |
| Terrell P Bishop | Psychiatry | Southeast Arkansas Behavioral Healthcare System Inc | 2500 Rike Dr, Pine Bluff, AR 71603-3937 |
| Cynthia G Slaughter | Clinical Social Worker | Southeast Arkansas Behavioral Healthcare System Inc | 2500 Rike Dr, Pine Bluff, AR 71603-3937 |
| Find all physicians in zip 71603 | |||
| City | PINE BLUFF |
| Zip Code | 71603 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | PINE BLUFF + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.