Healthcare Provider Details

I. General information

NPI: 1700945789
Provider Name (Legal Business Name): DUANE ABELS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 W ELM STREET
RAWLINS WY
82301
US

IV. Provider business mailing address

2221 W ELM STREET
RAWLINS WY
82301
US

V. Phone/Fax

Practice location:
  • Phone: 307-324-2221
  • Fax: 307-324-8232
Mailing address:
  • Phone: 307-324-2221
  • Fax: 307-324-8232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberWY 2916A
License Number StateWY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier107205600
Identifier TypeMEDICAID
Identifier StateWY
Identifier Issuer
# 2
Identifier1399310
Identifier TypeOTHER
Identifier StateWY
Identifier IssuerUMWA
# 3
Identifier185872500
Identifier TypeOTHER
Identifier StateWY
Identifier IssuerFEDERAL WORKERS COMP
# 4
Identifier104736100
Identifier TypeMEDICAID
Identifier StateWY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: