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General NPI Number Information
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NPI Number | 1033342563
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Entity Type | Organization
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Legal Business Name | THOMAS E. SPICER, MD, PC
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 1208 HILLTOP DR STE 103
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-5858
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Country | US
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Telephone | 307-362-8211
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Fax | 307-382-3451
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Provider Business Mailing Address
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Address Line | 1208 HILLTOP DR STE 103
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-5858
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Country | US
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Telephone | 307-362-8211
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Fax | 307-382-3451
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS E SPICER
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Credential | MD
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Telephone | 307-362-8211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 2513A
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License Number State | WY
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