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A WYOMING PAIN CLINIC P C NPI 1164804480


NPI Information

NPI: 1164804480
Provider Name: A WYOMING PAIN CLINIC P C

Doing Business As: POWDER RIVER PAIN CLINIC

Classification: Anesthesiology - 207LP2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 53D2114603

Address:
3100 W LAKEWAY RD
SUITE 3
GILLETTE, WY
ZIP 82718
Phone: (307) 696-1475
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A WYOMING PAIN CLINIC P C is a pain medicine anesthesiology in Gillette, WY. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. A WYOMING PAIN CLINIC P C NPI is 1164804480. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Powder River Pain Clinic.

The provider's business location address is:

3100 W LAKEWAY RD
SUITE 3
GILLETTE, WY
ZIP 82718-372
Phone: (307) 696-1475

The provider's authorized official is John L. Mansell .
The authorized official title is Provider and has the following contact phone number (307) 696-2996.

The CLIA number assigned to this NPI record is 53D2114603 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/23/2015 and was last updated on 1/23/2024.


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
1207L00000XAnesthesiology7144AWYOMINGNo
2261QP3300XClinic/CenterPain7144AWYOMINGNo
3207LP2900XAnesthesiologyPain Medicine7144AWYOMINGYes

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: 4/28/2024

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