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Organization

WYOMING ENDOCRINE & DIABETES CLINIC LLC

Active
Parent organization
WYOMING MEDICAL CENTER, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
WYOMING MEDICAL CENTER, INC.
Authorized official
MR. NATHAN STUTTE (EXTERNAL FINANCIAL CONTROLLER)
(307) 577-2767
Entity
Organization

Contact information

Practice address
940 E 3RD ST, SUITE 211, CASPER, WY 82601-3237
(307) 237-8400
(307) 233-0290
Mailing address
PO BOX 51106, CASPER, WY 82605
(307) 237-8400
(307) 233-0290

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06060001
BLUE CROSS BLUE SHIELD
WY
01
DF9300
RAILROAD MEDICARE
WY
Enumeration date
09/28/2006
Last updated
01/16/2008
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