Individual
EUGENE P PODRAZIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2210 KING BLVD., CASPER, WY 82604
(307) 577-4242
(307) 577-0012
Mailing address
2210 KING BLVD., CASPER, WY 82604
(307) 577-4242
(307) 577-0012
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
6478A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040015424
RAILROAD MEDICARE
—
05
—
115763900
—
WY
01
—
310642
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/15/2005
Last updated
06/26/2014
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