| Sheridan Neurology Pc | |
|
1050 Mydland Rd Sheridan WY 82801-2186 | |
| (307) 673-6300 | |
| (307) 673-6303 |
| Full Name | Sheridan Neurology Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1050 Mydland Rd, Sheridan, Wyoming |
| Authorized Official Name and Position | Jacque Reene Reed (OFFICE MANAGER) |
| Authorized Official Contact | 3076736300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sheridan Neurology Pc 1050 Mydland Rd Sheridan WY 82801-2186 Ph: (307) 673-6300 | Sheridan Neurology Pc 1050 Mydland Rd Sheridan WY 82801-2186 Ph: (307) 673-6300 |
| NPI Number | 1528113180 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 01/31/2011 |
| Medicare PECOS PAC ID | 1557312469 |
|---|---|
| Medicare Enrollment ID | O20050208001084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528113180 | NPI | - | NPPES |
| 148019300 | Other | WY | FEDERAL WORKERS COMP |
| 5696001 | Other | WI | WY BLUE SHIELD |
| 119441100 | Medicaid | WY | |
| 120469600 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 6950A (Wyoming) | Primary |
| Provider Name | Thomas O Mayer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104813930 PECOS PAC ID: 9638120546 Enrollment ID: I20050209000317 |
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