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General NPI Number Information
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NPI Number | 1194721050
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Entity Type | Organization
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Legal Business Name | HIGH PLAINS SURGICAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 06/24/2005
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 3100 W LAKEWAY RD STE 1
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City | GILLETTE
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State | WY
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Zip | 82718-6373
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Country | US
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Telephone | 307-682-7555
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Fax | 307-687-7243
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Provider Business Mailing Address
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Address Line | PO BOX 1272
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City | GILLETTE
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State | WY
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Zip | 82717-1272
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Country | US
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Telephone | 307-682-7555
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Fax | 307-687-7243
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | SARA L. HARTSAW
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Credential | MD
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Telephone | 307-682-7555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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