Healthcare Provider Details

I. General information

NPI: 1962494864
Provider Name (Legal Business Name): CASPER ORTHOPAEDIC ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4140 CENTENNIAL HILLS BLVD STE A
CASPER WY
82609-3265
US

IV. Provider business mailing address

4140 CENTENNIAL HILLS BLVD STE A
CASPER WY
82609-3265
US

V. Phone/Fax

Practice location:
  • Phone: 307-265-7205
  • Fax: 307-235-6262
Mailing address:
  • Phone: 307-265-7205
  • Fax: 307-235-6262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ERIC LINFORD
Title or Position: PRESIDENT
Credential: MD
Phone: 307-265-7205