Organization
BEAR RIVER SURGICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J OCONNOR MD (CEO)
(307) 798-1390
Entity
Organization
Contact information
Practice address
196 ARROWHEAD DR, SUITE #8, EVANSTON, WY 82930-8752
(307) 789-1390
(307) 789-1391
Mailing address
196 ARROWHEAD DR, SUITE #8, EVANSTON, WY 82930-8752
(435) 613-9500
(435) 613-9414
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100588000
—
WY
Enumeration date
04/26/2006
Last updated
04/25/2008
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