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General NPI Number Information
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NPI Number | 1629179247
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Entity Type | Individual
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Provider Name | MICHAEL W PRYOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 815 E MAIN ST
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City | LANDER
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State | WY
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Zip | 82520-3491
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Country | US
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Telephone | 307-332-9720
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Fax | 307-332-8206
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Provider Business Mailing Address
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Address Line | 815 E MAIN ST
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City | LANDER
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State | WY
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Zip | 82520-3491
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Country | US
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Telephone | 307-332-9720
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Fax | 307-332-8206
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 2769A
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0518540001
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License Number State | WY
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