NPI 1093961179 · live from the CMS NPI Registry
Stanford T Israelsen, MD
Orthopaedic Surgery in Gillette, WY. National Provider Identifier 1093961179, active.
NPI record
| NPI | 1093961179 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Orthopaedic Surgery 207X00000X |
| Practice location | 508 Stocktrail Ave, Suite A, Gillette, WY 82716 |
| Practice phone | 307-686-1413 |
| Enumerated | August 8, 2008 |
| Last updated | August 13, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthopaedic Surgery primary | 207X00000X | 9750A (WY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.