| Cesko Family Practice Pc | |
|
819 W Maple St Rawlins WY 82301-5462 | |
| (307) 324-3667 | |
| (307) 324-5591 |
| Full Name | Cesko Family Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 819 W Maple St, Rawlins, Wyoming |
| Authorized Official Name and Position | David R Cesko (OWNER) |
| Authorized Official Contact | 3073243667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cesko Family Practice Pc Po Box 40 Rawlins WY 82301-0040 Ph: (307) 324-3667 | Cesko Family Practice Pc 819 W Maple St Rawlins WY 82301-5462 Ph: (307) 324-3667 |
| NPI Number | 1366621476 |
|---|---|
| Provider Enumeration Date | 10/25/2007 |
| Last Update Date | 11/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366621476 | NPI | - | NPPES |
| 112705500 | Medicaid | WY | |
| DD4463 | Other | WY | PALMETTO ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5910A (Wyoming) | Primary |
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