# WYCO DERM LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Seitz Dermatology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043085020
- **Authorized official:** DR. GREGORY W SEITZ MD (OWNER)
- **Authorized official phone:** (307) 635-8299

## Contact information

- **Practice address:** 8305 WELLINGTON BLVD UNIT 102, WELLINGTON, CO 80549-2399
- **Practice address phone:** (307) 635-8299
- **Practice address fax:** (307) 635-6984
- **Mailing address:** 2112 SEYMOUR AVE, CHEYENNE, WY 82001-3830
- **Mailing address phone:** (307) 635-8299
- **Mailing address fax:** (307) 635-6984

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207ND0101X | MOHS-Micrographic Surgery Physician | — | NULL | — |
| 207ND0101X | MOHS-Micrographic Surgery Physician | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/20/2023
- **Last updated:** 11/20/2023