Organization
WIND RIVER ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY FOWLER MD (OWNER)
(208) 525-2090
Entity
Organization
Contact information
Practice address
1441 WILKINS CIRCLE, CASPER, WY 82601
(307) 265-1792
Mailing address
PO BOX 1363, IDAHO FALLS, ID 83403-1363
(208) 525-2090
(208) 525-2662
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
6058A
WY
Other
Enumeration date
01/18/2007
Last updated
03/11/2010
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