Individual
MATTHEW EUGENE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4140 CENTENNIAL HILLS BLVD, STE A, CASPER, WY 82609
(307) 265-7205
(307) 235-6262
Mailing address
4140 CENTENNIAL HILLS BLVD, STE A, CASPER, WY 82609-3265
(307) 265-7205
(307) 235-6262
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
7678A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
315174
BCBS OF WY
WY
01
—
P00412108
RAILROAD MEDICARE PTAN
WY
Enumeration date
05/15/2006
Last updated
06/13/2018
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