Organization
JACQUELINE D ADLER, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE D ADLER M.D. (SOLE PROPRIETOR)
(307) 674-0700
Entity
Organization
Contact information
Practice address
1333 W 5TH ST, SUITE 201, SHERIDAN, WY 82801-2751
(307) 674-0700
Mailing address
PO BOX 6046, SHERIDAN, WY 82801-1446
(307) 674-0700
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
7081A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121742900
—
WY
01
—
313871
BLUE CROSS BLUE SHIELD
WY
Enumeration date
01/22/2007
Last updated
05/19/2008
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