Organization
SUMMIT OB GYN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA WILSON (PRACTICE MANAGER)
(307) 682-6263
Entity
Organization
Contact information
Practice address
1414 W 4TH ST, GILLETTE, WY 82716-3328
(307) 299-4496
Mailing address
1414 W 4TH ST, GILLETTE, WY 82716-3328
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7203A
WY
174400000X
Specialist
8045A
WY
207V00000X
Obstetrics & Gynecology Physician
8335A
WY
Other
Enumeration date
04/13/2016
Last updated
03/15/2024
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