GROS VENTRE OB/GYN LLP NPI 1649451907

NPI Information

GROS VENTRE OB/GYN, LLP is an obstetrics gynecology in Jackson, WY. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. GROS VENTRE OB/GYN, LLP NPI is 1649451907. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

555 E BROADWAY AVE STE 108
JACKSON, WY
ZIP 83001-640
Phone: (307) 734-1005
Fax: (307) 734-1065

The provider's authorized official is Maura Lofaro .
The authorized official title is Owner and has the following contact phone number (307) 734-1005.

The CLIA number assigned to this NPI record is 53D2038409 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/15/2007 and was last updated on 9/17/2012.

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:

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