# W.MICHAEL CROSBY M.D. PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093063596
- **Authorized official:** MR. MICAHEL CROSBY M.D. (OWNER)
- **Authorized official phone:** (208) 525-2090

## Contact information

- **Practice address:** 1503 CRESSETT ST, GILLETTE, WY 82716-3339
- **Practice address phone:** (208) 525-2090
- **Practice address fax:** (208) 526-2662
- **Mailing address:** 1601 E 17TH ST, IDAHO FALLS, ID 83404-6313
- **Mailing address phone:** (208) 525-2090
- **Mailing address fax:** (208) 525-2662

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 4201A | WY | Yes |

## Other

- **Enumeration date:** 08/15/2012
- **Last updated:** 08/15/2012