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Organization
WESTERN AMBULATORY SURGERY LLC
Active
Organization
WESTERN AMBULATORY SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW TAYLOR DODDS M.D (OWNER)
(307) 237-2511
Entity
Organization
Contact information
Practice address
1421 WILKINS CIR, CASPER, WY 82601-1337
(307) 237-2511
(307) 237-7351
Mailing address
1421 WILKINS CIR, CASPER, WY 82601-1337
(307) 237-2511
(307) 237-7351
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
06-188
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00313001
BLUE CROSS BLUE SHIELD
WY
05
—
115653500
—
WY
Enumeration date
06/13/2006
Last updated
11/19/2015
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