Organization
WYOMING ORTHOPEDIC AND SPORTS MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE D SMITH M.D. (OWNER)
(307) 633-7943
Entity
Organization
Contact information
Practice address
5050 POWDERHOUSE RD, CHEYENNE, WY 82009-4800
(307) 633-7943
(307) 432-2676
Mailing address
PO BOX 21330, CHEYENNE, WY 82003-7026
(307) 633-7943
(307) 432-2676
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
WY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
WY
363A00000X
Physician Assistant
—
WY
Other
Enumeration date
07/06/2007
Last updated
08/28/2007
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