MEDICARE: HIGH PLAINS GENERAL SURGERY INC

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	208600000X	Surgery Physician	2625A	WY

General Provider Information

NPI Number	:	1912098211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGH PLAINS GENERAL SURGERY INC

Provider Business Mailing Address
First Line	:	204 MCCOLLUM DR
Second Line	:	SUITE 101
City	:	LARAMIE
State	:	WY
Zip	:	82070-5151
Country	:	US
Telephone Number	:	307-745-9099
Fax Number	:	307-745-4936

Provider Business Practice Location Address
First Line	:	204 MCCOLLUM DR
Second Line	:	SUITE 101
City	:	LARAMIE
State	:	WY
Zip	:	82070-5151
Country	:	US
Telephone Number	:	307-745-9099
Fax Number	:	307-745-4936

Authorized Official
Title or Position	:	CEO
Name	:	DR. GEORGE S HAIGNT III
Credential	:	MD
Telephone Number	:	307-745-9099

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	08/22/2020

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