Individual
DR. CALVIN GARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1008 FELDSPAR COURT, HANNA, WY 82327
(307) 325-6596
(307) 325-6597
Mailing address
PO BOX 689, HANNA, WY 82327-0689
(307) 325-6596
(307) 325-6597
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
WY215
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00863001
BLUE CROSS BLUE SHIELD
WY
01
—
1399310
UMWA
WY
01
—
83600002582327A002
TRICARE
WY
01
—
P00029818
RR MEDICARE
WY
Enumeration date
11/08/2006
Last updated
12/17/2007
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