Individual
TOM A NACHTIGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3125 E GRAND AVE, SUITE B, LARAMIE, WY 82070-5137
(307) 745-8442
(307) 742-0036
Mailing address
PO BOX 103, LARAMIE, WY 82073-0103
(307) 760-8468
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4490A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116885100
—
WY
Enumeration date
11/09/2006
Last updated
07/31/2018
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