# WIND RIVER PEDIATRICS, LLC

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

## Provider details

- **NPI number:** 1215976253
- **Authorized official:** MICHAEL R FISHER MD (CEO)
- **Authorized official phone:** (307) 857-5247

## Contact information

- **Practice address:** 1005 COLLEGE VIEW DR, RIVERTON, WY 82501-2266
- **Practice address phone:** (307) 857-5247
- **Practice address fax:** (307) 857-5215
- **Mailing address:** 1005 COLLEGE VIEW DR, RIVERTON, WY 82501-2266
- **Mailing address phone:** (307) 857-5247
- **Mailing address fax:** (307) 857-5215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 7224A | WY | Yes |

## Other

- **Enumeration date:** 06/05/2006
- **Last updated:** 08/22/2020