# BIG HORN UROLOGY PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dr Stephen W Holst MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043379472
- **Authorized official:** DR. STEPHEN WILSON HOLST MD (PRESIDENT BIG HORN UROLOGY PC)
- **Authorized official phone:** (307) 672-1806

## Contact information

- **Practice address:** 340 WEST DOW STREET, SHERIDAN, WY 82801
- **Practice address phone:** (307) 672-1806
- **Practice address fax:** (307) 672-1808
- **Mailing address:** 340 WEST DOW STREET, SHERIDAN, WY 82801
- **Mailing address phone:** (307) 672-1806
- **Mailing address fax:** (307) 672-1808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 2157 | CO | — |
| 208800000X | Urology Physician | 5434A | WY | Yes |

## Other

- **Enumeration date:** 12/08/2006
- **Last updated:** 06/10/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 109407600 | — | WY |
| 01 | — | 306592 | BLUE CROSS BLUE SHIELD | WY |