Organization
BIG HORN BASIN ORTHOPEDIC CLINIC , PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA J CARLSON (BUSINESS MANAGER)
(307) 578-1975
Entity
Organization
Contact information
Practice address
720 LINDSAY LN, CODY, WY 82414-4103
(307) 578-1900
Mailing address
720 LINDSAY LN, CODY, WY 82414-4103
(307) 578-1900
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30505047
—
MT
01
—
955001
BLUE CROSS BLUE SHIELD
WY
Enumeration date
09/26/2006
Last updated
08/22/2020
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