| Marc F Domsky, DO | |
|
625 E Broadway, Jackson, WY 83001 | |
| (307) 739-7218 | |
| Not Available |
| Full Name | Marc F Domsky |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Location | 625 E Broadway, Jackson, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821103268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 6732A (Wyoming) | Primary |
| Entity Name | Grand Anesthesiology Services PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477567246 PECOS PAC ID: 3375583586 Enrollment ID: O20050506000544 |
| Mailing Address | Practice Location Address |
|---|---|
| Marc F Domsky, DO Po Box 13130, Jackson, WY 83002-3130 Ph: Not Available | Marc F Domsky, DO 625 E Broadway, Jackson, WY 83001 Ph: (307) 739-7218 |
Charles Lee Payne, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 970 W Broadway # 378, Jackson, WY 83001 Phone: 307-734-6956 |
Philip C Blum, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 150 Buffalo Way, Jackson, WY 83002 Phone: 307-733-8677 |
Dr. David J Tomlinson, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 625 E Broadway, Jackson, WY 83002 Phone: 307-739-7218 Fax: 307-739-7446 |