Individual
GERALD LYNN PAXTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
905 BRIDGER DR, GREEN RIVER, WY 82935-5879
(307) 875-7841
(307) 875-0166
Mailing address
905 BRIDGER DR, GREEN RIVER, WY 82935-5879
(307) 875-7841
(307) 875-0166
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2502
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103142-253
DRIVERS LICENSE NUMBER
WY
Enumeration date
10/01/2008
Last updated
10/01/2008
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