Organization
ANESTHESIA SERVICES OF JACKSONHOLE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES L. PAYNE JR. M.D. (PRESIDENT)
(307) 734-6956
Entity
Organization
Contact information
Practice address
970 W BROADWAY # 378, JACKSON, WY 83001-9475
(307) 734-6956
Mailing address
970 W BROADWAY # 378, JACKSON, WY 83001-9475
(307) 734-6956
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
6301A
WY
Other
Enumeration date
08/29/2007
Last updated
08/29/2007
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