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Individual

PATRICK W. TUFTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
255 N 30TH ST, LARAMIE, WY 82072-5140
(307) 755-4406
Mailing address
255 N 30TH ST, LARAMIE, WY 82072-5140
(307) 755-4406

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10857
MT
207Q00000X
Family Medicine Physician
2015003661
MO
207Q00000X
Family Medicine Physician
Primary
8720A
WY
207Q00000X
Family Medicine Physician
M-12773
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
044885
MT
01
84761
MEDICARE PART B
MT
01
99758
BC/BS OF MONTANA
Enumeration date
08/16/2006
Last updated
01/04/2017
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