Organization
YELLOWSTONE SPORTS MEDICINE AND BONE & JOINT CLINIC,LLC
Active
Other names
Yellowstone Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIMMIE GENE BILES M.D. (MANAGING MEMBER)
(307) 578-1953
Entity
Organization
Contact information
Practice address
720 LINDSAY LN, SUITE B, CODY, WY 82414-4103
(307) 578-1992
(307) 578-1990
Mailing address
720 LINDSAY LN, SUITE B, CODY, WY 82414-4103
(307) 578-1992
(307) 578-1990
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
3909A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W22409
MEDICARE PTAN
—
Enumeration date
02/29/2008
Last updated
05/05/2009
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