Organization
WOMENS CLINIC OF NORTHEASTERN WYOMING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY JAMES SCOTT MD (PRESIDENT OF PC)
(307) 672-0401
Entity
Organization
Contact information
Practice address
212 W BURKITT ST, SHERIDAN, WY 82801-4206
(307) 672-0401
(307) 672-0317
Mailing address
212 W BURKITT ST, SHERIDAN, WY 82801-4206
(307) 672-0401
(307) 672-0317
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2719A
WY
363L00000X
Nurse Practitioner
13730119
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107189100
—
WY
Enumeration date
11/13/2006
Last updated
10/10/2007
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