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NPI Code Detail

MEDICARE: THOMAS E. SPICER, MD, PC

MEDICARE: THOMAS E. SPICER, MD, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center2513AWY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
124000693OTHERWYRAILROA MEDICARE GROUP NUMBER PTAN
4240000693OTHERWYRAILROAD MEDICARE
5W308595OTHERWYMEDICARE GROUP
6W308596OTHERWYKRIS SHERWIN PA-C MEDICARE NUMBER
9DN9829OTHERWYRAILROAD MEDICARE GROUP PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
218368920147OTHERWYKRIS SHERWIN, PA-C NPI NUMBER
31093998098OTHERWYTHOMAS E. SPICER, MD GROUP NPI NUMBER
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
81821171349OTHERWYTHOMAS E. SPICER NPI NUMBER

General Provider Information

NPI Number : 1033342563
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOMAS E. SPICER, MD, PC
Provider Business Mailing Address
First Line : 1208 HILLTOP DR STE 103
Second Line :
City : ROCK SPRINGS
State : WY
Zip : 82901-5858
Country : US
Telephone Number : 307-362-8211
Fax Number : 307-382-3451
Provider Business Practice Location Address
First Line : 1208 HILLTOP DR STE 103
Second Line :
City : ROCK SPRINGS
State : WY
Zip : 82901-5858
Country : US
Telephone Number : 307-362-8211
Fax Number : 307-382-3451
Authorized Official
Title or Position : OWNER
Name : DR. THOMAS E SPICER
Credential : MD
Telephone Number : 307-362-8211
Provider Enumeration Date : 09/01/2009
Last Update Date : 09/01/2009

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Directions to “THOMAS E. SPICER, MD, PC ” Practice Location

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