MEDICARE: BEARTOOTH ORTHOPAEDIC & SPINE 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
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1376765826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEARTOOTH ORTHOPAEDIC & SPINE PC

Provider Business Mailing Address
First Line	:	702 PLATINUM AVE
Second Line	:
City	:	CODY
State	:	WY
Zip	:	82414-3423
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	702 PLATINUM AVE
Second Line	:
City	:	CODY
State	:	WY
Zip	:	82414-3423
Country	:	US
Telephone Number	:	307-250-6052
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEPHEN F. EMERY
Credential	:	M.D.
Telephone Number	:	307-250-2523

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	05/09/2017

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