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Organization

GEM CITY BONE & JOINT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TRENT KAUFMAN (ADMINISTRATOR)
(307) 745-8851
Entity
Organization

Contact information

Practice address
2250 COLLEGE DR, ROCK SPRINGS, WY 82901
(307) 745-8851
Mailing address
1909 VISTA DR, LARAMIE, WY 82070-5530
(307) 745-8851

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
315770
BLUE CROSS BLUE SHIELD OF WYOMING
WY
Enumeration date
07/24/2008
Last updated
07/24/2008
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