MEDICARE: DR. ALBERT LOUIS STEPLOCK JR. M.D.

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
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	3785A	WY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	060046935	OTHER	WY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	307514	OTHER	WY	BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366445926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT LOUIS STEPLOCK JR. M.D.

Provider Business Mailing Address
First Line	:	805 E 2ND ST
Second Line	:	STE 3
City	:	CASPER
State	:	WY
Zip	:	82601-2641
Country	:	US
Telephone Number	:	307-237-2300
Fax Number	:	307-237-1346

Provider Business Practice Location Address
First Line	:	805 E 2ND ST
Second Line	:	STE 3
City	:	CASPER
State	:	WY
Zip	:	82601-2641
Country	:	US
Telephone Number	:	307-237-2300
Fax Number	:	307-237-1346

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	12/01/2010

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Directions to “ DR. ALBERT LOUIS STEPLOCK JR. M.D.” Practice Location

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