Organization
WYOMING RECONSTRUCTIVE & PLASTIC SURGERY LLC
Active
Parent organization
WYOMING MEDICAL CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
WYOMING MEDICAL CENTER, INC.
Authorized official
MR. NATHAN STUTTE (EXTERNAL FINANCIAL CONTROLLER)
(307) 577-2767
Entity
Organization
Contact information
Practice address
918 E 2ND ST, CASPER, WY 82601-2625
(307) 472-4300
(307) 472-4311
Mailing address
PO BOX 51076, CASPER, WY 82605
(307) 472-4300
(307) 472-4311
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06059001
BLUE CROSS BLUE SHIELD
WY
01
—
DF9302
RAILROAD MEDICARE
WY
Enumeration date
09/28/2006
Last updated
01/16/2008
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