Organization
WYOMING CANCER SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH R MILLS MD (OWNER)
(307) 382-5116
Entity
Organization
Contact information
Practice address
400 2ND ST, SUITE D, ROCK SPRINGS, WY 82901-6260
(307) 382-5116
(307) 382-5118
Mailing address
3576 GARDEN CREEK HTS, CASPER, WY 82601-6644
(307) 262-5949
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
6639A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05922001
BCBS
WY
05
—
122649500
—
WY
Enumeration date
01/29/2007
Last updated
11/06/2008
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