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Organization
WOMENS CLINIC OF NORTHEASTERN WYOMING PC
Active
Organization
WOMENS CLINIC OF NORTHEASTERN WYOMING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY JAMES SCOTT MD (PRESIDENT OF PC)
(307) 672-0401
Entity
Organization
Contact information
Practice address
212 W BURKITT ST, SHERIDAN, WY 82801-4206
(307) 672-0401
(307) 672-0317
Mailing address
212 W BURKITT ST, SHERIDAN, WY 82801-4206
(307) 672-0401
(307) 672-0317
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2719A
WY
363L00000X
Nurse Practitioner
13730119
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107189100
—
WY
Enumeration date
11/13/2006
Last updated
10/10/2007
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