Organization
SAGEBRUSH E.N.T., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIGSBEE WALTER DUCK M.D. (PRESIDENT)
(307) 685-1442
Entity
Organization
Contact information
Practice address
1405 W 4TH ST, GILLETTE, WY 82716-3327
(307) 685-1442
Mailing address
1405 W 4TH ST, GILLETTE, WY 82716-3327
(307) 685-1442
Taxonomy
Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
Primary
5649A
WY
332S00000X
Hearing Aid Equipment
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11403101
—
WY
01
—
15228261161
NPI
WY
Enumeration date
06/11/2007
Last updated
01/28/2008
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