Organization
THOMAS E SPICER, MD-PC
Active
Other names
Thomas E Spicer MD
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A PADILLA (OFFICE MANAGER)
(307) 362-8211
Entity
Organization
Contact information
Practice address
1208 HILLTOP DR, SUITE 103, ROCK SPRINGS, WY 82901-5857
(307) 362-8211
Mailing address
1208 HILLTOP DR, SUITE 103, ROCK SPRINGS, WY 82901-5857
(307) 362-8211
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
2513A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1103963600
—
WY
01
—
302359
BCBS PROVIDER NUMBER
WY
01
—
W308595
MEDICARE GROUP NUMBER
WY
01
—
W308597
MEDICARE PROVIDER NUMBER
WY
Enumeration date
12/12/2007
Last updated
12/12/2007
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