Organization
LAWRENCE W OHOLLERAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE WILLIAM OHOLLERAN MD (SURGEON)
(307) 637-5600
Entity
Organization
Contact information
Practice address
1616 E 19TH ST, STE 8, CHEYENNE, WY 82001-4946
(307) 637-5600
(307) 637-0249
Mailing address
1616 E 19TH ST, STE 8, CHEYENNE, WY 82001-4946
(307) 637-5600
(307) 637-0249
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
16963
NE
208600000X
Surgery Physician
26688
CO
208600000X
Surgery Physician
Primary
6423A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115489300
—
WY
01
—
COA106329/COA106330
MEDICARE/TRAILBLAZER HEALTH ENTERPRISES
—
Enumeration date
03/22/2006
Last updated
09/09/2011
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