| Scott D Bennion, MD | |
|
2546 E 2nd St Ste 400, Casper, WY 82609-2062 | |
| (307) 234-0003 | |
| Not Available |
| Full Name | Scott D Bennion |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Location | 2546 E 2nd St Ste 400, Casper, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952317505 | NPI | - | NPPES |
| 37485865 | Medicaid | CO | |
| 114196100 | Medicaid | WY | |
| 070014069 | Other | WY | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 34844 (Colorado) | Secondary |
| 207N00000X | Dermatology | 3201A (Wyoming) | Primary |
| Entity Name | Central Wyoming Skin Clinic Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588851547 PECOS PAC ID: 7416930649 Enrollment ID: O20040609001098 |
| Mailing Address | Practice Location Address |
|---|---|
| Scott D Bennion, MD 2546 E 2nd St Ste 400, Casper, WY 82609-2062 Ph: (307) 234-0003 | Scott D Bennion, MD 2546 E 2nd St Ste 400, Casper, WY 82609-2062 Ph: (307) 234-0003 |
Rowan E Tichenor, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1119 E 3rd St, Casper, WY 82601 Phone: 307-266-2772 Fax: 307-266-2076 | |
Tyler Lee Quest, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1119 E 3rd St, Casper, WY 82601 Phone: 307-266-2772 Fax: 307-266-2076 |