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NPI Code Detail

MEDICARE: CITADEL ANESTHESIA CONSULTANTS PC

MEDICARE: CITADEL ANESTHESIA CONSULTANTS 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
1207L00000XAnesthesiology Physician9249AWY

General Provider Information

NPI Number : 1851725279
Entity Type Code : Organization
Provider Name (Legal Business Name) : CITADEL ANESTHESIA CONSULTANTS PC
Provider Business Mailing Address
First Line : 111 W 2ND ST STE 415
Second Line :
City : CASPER
State : WY
Zip : 82601-2467
Country : US
Telephone Number : 307-237-5848
Fax Number : 307-261-9818
Provider Business Practice Location Address
First Line : 1233 EAST 2ND STREET
Second Line :
City : CASPER
State : WY
Zip : 82601-2988
Country : US
Telephone Number : 307-577-7201
Fax Number :
Authorized Official
Title or Position : MD
Name : NATHAN G. PUTNAM
Credential : MD
Telephone Number : 307-237-5848
Provider Enumeration Date : 08/22/2013
Last Update Date : 01/03/2014

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Directions to “CITADEL ANESTHESIA CONSULTANTS PC ” Practice Location

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