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Organization

UROLOGICAL SERVICES OF NORTHERN WYOMING PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREGORY S STEWART M.D. (OWNER)
(307) 587-5131
Entity
Organization

Contact information

Practice address
225 W YELLOWSTONE AVE, SUITE #9, CODY, WY 82414-8702
(307) 587-5131
(307) 587-5132
Mailing address
225 W YELLOWSTONE AVE, CODY, WY 82414-8702
(307) 587-5131
(307) 587-5132

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
7308A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122121300
WY
01
314014
BLUE CROSS BLUE SHIELD
WY
01
611975900
FEDERAL WORK COMP
01
DF1105
RAILROAD MEDICARE
Enumeration date
02/24/2006
Last updated
04/26/2019
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