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NPI Code Detail

MEDICARE: WYOMING OTOLARYNGOLOGY, P.C.

MEDICARE: WYOMING OTOLARYNGOLOGY, P.C.
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
1332S00000XHearing Aid Equipment
2207Y00000XOtolaryngology PhysicianWY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578511036
Entity Type Code : Organization
Provider Name (Legal Business Name) : WYOMING OTOLARYNGOLOGY, P.C.
Provider Business Mailing Address
First Line : 6500 E 2ND ST
Second Line : SUITE 101
City : CASPER
State : WY
Zip : 82609-4338
Country : US
Telephone Number : 307-577-4242
Fax Number : 307-577-0012
Provider Business Practice Location Address
First Line : 6500 E 2ND ST
Second Line : SUITE 101
City : CASPER
State : WY
Zip : 82609-4338
Country : US
Telephone Number : 307-577-4242
Fax Number : 307-577-0012
Authorized Official
Title or Position : OFFICE MANAGER
Name : SHELIA S ELLIOTT
Credential :
Telephone Number : 307-577-4242
Provider Enumeration Date : 05/05/2006
Last Update Date : 07/15/2011

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6500 E 2ND ST , SUITE 200
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82609-4338
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1356349054 — WERNER A STUDER MD
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1467448043 — JOSEPH EDWARD MICKELSON MD
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82609-4338
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Practice Fax: 307-234-1201
1609862580 — JENNIFER LYNN FRARY PA-C
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82609-4338
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1841214954 — JONATHAN P BINDER MD
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CASPER, WY
82609-4338
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1124034566 — SHERRILL A FOX M.D.
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82609-4338
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Practice Fax: 307-234-1201

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