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General NPI Number Information
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NPI Number | 1922582402
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Entity Type | Organization
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Legal Business Name | WYOMING EYE SURGEONS
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 10/31/2019
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Provider Practice Location Address
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Address Line | 36 N. GOULD ST. SUITE 2A
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City | SHERIDAN
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State | WY
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Zip | 82801
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Country | US
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Telephone | 559-246-8254
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Fax |
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Provider Business Mailing Address
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Address Line | 23 MOONLIGHT DR
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City | SHERIDAN
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State | WY
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Zip | 82801-8627
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Country | US
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Telephone | 559-246-8254
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BAIRN MICHAEL WALKER
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Credential | MD
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Telephone | 559-246-8254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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