Healthcare Provider Details

I. General information

NPI: 1508823964
Provider Name (Legal Business Name): JOSEPH FORREST ALLEGRETTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 01/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 POWDER BASIN AVE
GILLETTE WY
82718-6406
US

IV. Provider business mailing address

PO BOX 688
DOUGLAS WY
82633-0688
US

V. Phone/Fax

Practice location:
  • Phone: 307-682-6222
  • Fax: 307-682-6999
Mailing address:
  • Phone: 307-682-6222
  • Fax: 307-682-6999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number5328A
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: