| Pauljordanwashburnmd, Llc. | |
|
5720 Osage Ave 3-301 Cheyenne WY 82009-3948 | |
| (970) 518-9394 | |
| Not Available |
| Full Name | Pauljordanwashburnmd, Llc. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 5720 Osage Ave, Cheyenne, Wyoming |
| Authorized Official Name and Position | Paul Jordan Washburn (OWN, PHYSICIAN) |
| Authorized Official Contact | 9705189394 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pauljordanwashburnmd, Llc. 5720 Osage Ave 3-301 Cheyenne WY 82009-3948 Ph: (970) 518-9394 | Pauljordanwashburnmd, Llc. 5720 Osage Ave 3-301 Cheyenne WY 82009-3948 Ph: (970) 518-9394 |
| NPI Number | 1114452166 |
|---|---|
| Provider Enumeration Date | 04/27/2017 |
| Last Update Date | 04/27/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114452166 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 10738A (Wyoming) | Primary |
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