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CUSTOM ORTHOPEDICS OF WYO. LLC NPI 1013952670


NPI Information

NPI: 1013952670
Provider Name: CUSTOM ORTHOPEDICS OF WYO. LLC
Classification: Specialist - 1744P3200X
Entity Type: Organization

Specialization: Prosthetics Case Management

Address:
240 W 9TH ST
CASPER, WY
ZIP 82601
Phone: (307) 237-3688
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CUSTOM ORTHOPEDICS OF WYO. LLC is a prosthetics case management specialist in Casper, WY. CUSTOM ORTHOPEDICS OF WYO. LLC NPI is 1013952670. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

240 W 9TH ST
CASPER, WY
ZIP 82601-708
Phone: (307) 237-3688
Fax: (307) 237-3696

The provider's authorized official is Nancy O Jackson .
The authorized official title is Office Manager and has the following contact phone number (307) 237-3688.

The enumeration date for this NPI number is 6/18/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11744P3200XSpecialistProsthetics Case ManagementYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
110025302700MEDICAIDNEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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