| Dr Lucy Haberthier-ryan, MD | |
|
1180 College Dr, Rock Springs, WY 82901-5863 | |
| (307) 212-7717 | |
| (307) 212-7513 |
| Full Name | Dr Lucy Haberthier-ryan |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1180 College Dr, Rock Springs, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265449060 | NPI | - | NPPES |
| 0020ED | Other | TX | BLUECROSS/BLUESHIELD |
| 130812404 | Medicaid | TX | |
| 10020015 | Other | TX | AMERIGROUP |
| 5695001 | Other | TX | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | J5094 (Texas) | Secondary |
| 208000000X | Pediatrics | 12406A (Wyoming) | Primary |
| Entity Name | Utmb Faculty Group Practice |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942241146 PECOS PAC ID: 3375456734 Enrollment ID: O20031112000438 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Lucy Haberthier-ryan, MD Po Box 1359, Rock Springs, WY 82902-1359 Ph: (307) 212-7717 | Dr Lucy Haberthier-ryan, MD 1180 College Dr, Rock Springs, WY 82901-5863 Ph: (307) 212-7717 |
Dr. William O Sarette, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1200 College Dr, Rock Springs, WY 82901 Phone: 307-362-3711 Fax: 307-352-8454 | |
Dr. Chandrashekar Yeshlur, M.D Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1204 Hilltop Dr, Suite # 106, Rock Springs, WY 82901 Phone: 307-362-5500 Fax: 307-362-0300 |