# CASPER PEDIATRICS

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

## Provider details

- **NPI number:** 1205121209
- **Authorized official:** DR. AMBROSE SOLER M.D. (OWNER)
- **Authorized official phone:** (307) 265-2400

## Contact information

- **Practice address:** 1300 E A ST, SUITE 206, CASPER, WY 82601-2260
- **Practice address phone:** (307) 265-2400
- **Practice address fax:** (307) 265-2566
- **Mailing address:** 1300 E A ST, SUITE 206, CASPER, WY 82601-2260
- **Mailing address phone:** (307) 265-2400
- **Mailing address fax:** (307) 265-2566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 8373A | WY | Yes |

## Other

- **Enumeration date:** 06/17/2011
- **Last updated:** 06/17/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1710915525 | BCBS | WY |
| 05 | — | 1710915525 | — | WY |