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Organization
BIG HORN UROLOGY PC
Active
Organization
BIG HORN UROLOGY PC
Active
Other names
Dr Stephen W Holst MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN WILSON HOLST MD (PRESIDENT BIG HORN UROLOGY PC)
(307) 672-1806
Entity
Organization
Contact information
Practice address
340 WEST DOW STREET, SHERIDAN, WY 82801
(307) 672-1806
(307) 672-1808
Mailing address
340 WEST DOW STREET, SHERIDAN, WY 82801
(307) 672-1806
(307) 672-1808
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
2157
CO
208800000X
Urology Physician
Primary
5434A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109407600
—
WY
01
—
306592
BLUE CROSS BLUE SHIELD
WY
Enumeration date
12/08/2006
Last updated
06/10/2010
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