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NPI Code Detail

MEDICARE: RURAL SPINE CARE PC

MEDICARE: RURAL SPINE CARE 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
1207XS0117XOrthopaedic Surgery of the Spine Physician10140AWY

General Provider Information

NPI Number : 1376079962
Entity Type Code : Organization
Provider Name (Legal Business Name) : RURAL SPINE CARE PC
Provider Business Mailing Address
First Line : 4401 COLLEGE DR
Second Line :
City : ROCK SPRINGS
State : WY
Zip : 82901-3507
Country : US
Telephone Number : 307-352-8946
Fax Number :
Provider Business Practice Location Address
First Line : 4401 COLLEGE DR
Second Line :
City : ROCK SPRINGS
State : WY
Zip : 82901-3507
Country : US
Telephone Number : 970-819-0697
Fax Number :
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : HENRY FABIAN JR.
Credential : MD
Telephone Number : 970-819-0697
Provider Enumeration Date : 05/03/2017
Last Update Date : 02/19/2025

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Directions to “RURAL SPINE CARE PC ” Practice Location

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