# UROLOGY CARE CLINIC, P.C.

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

## Provider details

- **NPI number:** 1780754317
- **Authorized official:** MS. EDITH DIANE WILSON M.D. (OWNER)
- **Authorized official phone:** (307) 632-3111

## Contact information

- **Practice address:** 433 E 19TH ST, CHEYENNE, WY 82001-4643
- **Practice address phone:** (307) 632-3111
- **Practice address fax:** (307) 778-8649
- **Mailing address:** 433 E 19TH ST, CHEYENNE, WY 82001-4643
- **Mailing address phone:** (307) 632-3111
- **Mailing address fax:** (307) 778-8649

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 5500A | WY | Yes |

## Other

- **Enumeration date:** 11/09/2006
- **Last updated:** 08/22/2020