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Individual

MR. ANDREW WILLIAM BAUKOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1909 VISTA DR, LARAMIE, WY 82070-5599
(307) 745-8851
(307) 742-0961
Mailing address
1909 VISTA DR, LARAMIE, WY 82070-5599
(307) 745-8851
(307) 742-0961

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5322
AZ
363A00000X
Physician Assistant
PT925
WY
363AS0400X
Surgical Physician Assistant
PA-1379
ID
363AS0400X
Surgical Physician Assistant
Primary
PT925
WY
363AS0400X
Surgical Physician Assistant
SC

Other

Enumeration date
12/05/2012
Last updated
04/15/2021
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