Individual
AIDA R POLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
777 AVENUE H, POWELL, WY 82435-2260
(307) 754-7257
(307) 754-7730
Mailing address
777 AVENUE H, POWELL, WY 82435
(307) 754-7257
(307) 857-5215
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7734A
WY
207R00000X
Internal Medicine Physician
M-9474
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881649655
—
WY
Enumeration date
05/23/2006
Last updated
03/23/2016
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