Individual
DR. LAURENCE WILLIAM VALE DEBOER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
430 MEDICAL ARTS CT., GILLETTE, WY 82716
(307) 682-7661
(307) 682-7624
Mailing address
430 MEDICAL ARTS CT., GILLETTE, WY 82716
(307) 682-7661
(307) 682-7624
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
5853A
WY
207RC0000X
Cardiovascular Disease Physician
E0878
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00783001
BLUE CROSS GROUP NUMBER
WY
01
—
303946
BLUE CROSS
WY
01
—
53D925429
CLIA
WY
01
—
5853A
STATE LICENSE
WY
01
—
638
MEDICAL LICENSE
—
05
—
7088727
—
WY
05
—
8380925
—
WA
Enumeration date
09/14/2006
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us