Organization
JACQUES D. BEVERIDGE MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDERICK J ZEBROSKI (MANAGER)
(307) 332-2223
Entity
Organization
Contact information
Practice address
1460 MAIN ST, SUITE B, LANDER, WY 82520-2657
(307) 332-2223
Mailing address
1460 MAIN ST, SUITE B, LANDER, WY 82520-2657
(307) 332-2223
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
6275A
WY
367A00000X
Advanced Practice Midwife
8746.0044
WY
Other
Enumeration date
03/07/2007
Last updated
10/24/2007
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