Healthcare Provider Details

I. General information

NPI: 1831442250
Provider Name (Legal Business Name): WILLIAM ALAN BUXTON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 10/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 WILKINS CIR
CASPER WY
82601-1336
US

IV. Provider business mailing address

1430 WILKINS CIR
CASPER WY
82601-1336
US

V. Phone/Fax

Practice location:
  • Phone: 307-237-9583
  • Fax: 307-265-7277
Mailing address:
  • Phone: 307-237-9583
  • Fax: 307-265-7277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-813
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: