Organization
MARK P MENOLASCINO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK P MENOLASCINO MD (OWNER)
(307) 732-1039
Entity
Organization
Contact information
Practice address
5235 HHR RANCH ROAD, WILSON, WY 83014
(307) 732-1039
(307) 732-1041
Mailing address
PO BOX 4816, JACKSON, WY 83001-4816
(307) 732-1039
(307) 732-1041
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6730A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118685000
—
WY
Enumeration date
02/06/2008
Last updated
06/17/2016
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