Individual
DR. THOMAS E RADOSEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 N C AVE, THERMOPOLIS, WY 82443-2410
(307) 864-5534
Mailing address
231 S WILSON ST, CASPER, WY 82601-2941
(307) 234-6161
(307) 234-7033
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5976A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117895400
—
WY
Enumeration date
06/11/2006
Last updated
08/29/2019
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