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Organization
ANESTHESIA SERVICES OF JACKSONHOLE, P.C.
Active
Organization
ANESTHESIA SERVICES OF JACKSONHOLE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES L. PAYNE JR. M.D. (PRESIDENT)
(307) 734-6956
Entity
Organization
Contact information
Practice address
970 W BROADWAY # 378, JACKSON, WY 83001-9475
(307) 734-6956
Mailing address
970 W BROADWAY # 378, JACKSON, WY 83001-9475
(307) 734-6956
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
6301A
WY
Other
Enumeration date
08/29/2007
Last updated
08/29/2007
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