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WALLACE GOFORTH, CRNA
CRNA
Certified Registered Nurse Anesthetist
NPI: 1497295901IndividualAccepts Medicare
Specialties, Licenses & Credentials
Certified Registered Nurse AnesthetistPrimary
Nurse Anesthetist, Certified Registered
Code: 367500000X
1113831(TX)209016165(IL)857695(NY)
Registered Nurse
Registered Nurse
Code: 163W00000X
041.449328(IL)
CMS Specialties
PrimaryCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Education
OTHER
Class of 2017
Contact & Hours
Via practice · 2 locations total
- Address
- 405 W JACKSON ST
CARBONDALE, IL 62901 - Phone
- (618) 549-0721
Quick Facts
- NPI
- 1497295901
- Entity Type
- Individual
- Gender
- Male
- Medicare
- Accepted
- Specialties
- 4
- Locations
- 2
- Years in Practice
- 9
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