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Organization
GEM CITY BONE & JOINT PC
Active
Organization
GEM CITY BONE & JOINT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA SUAZO (DIRECTOR OF HUMAN RESOURCES)
(307) 745-8851
Entity
Organization
Contact information
Practice address
1909 VISTA DR, LARAMIE, WY 82070
(307) 745-8851
(307) 742-0961
Mailing address
1909 VISTA DR, LARAMIE, WY 82070
(307) 745-8851
(307) 742-0961
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
06018
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106251401
—
WY
05
—
106251403
—
WY
01
—
303849
BCBS
—
01
—
490003442
RAILROAD MEDICARE
—
Enumeration date
01/18/2006
Last updated
01/21/2021
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