| Frontier Neurosciences, Llc | |
|
1008 13th St Suite A Cody WY 82414-3677 | |
| (307) 578-1985 | |
| (307) 578-1938 |
| Full Name | Frontier Neurosciences, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1008 13th St, Cody, Wyoming |
| Authorized Official Name and Position | Michelle R Lemmon (OFFICE MANAGER) |
| Authorized Official Contact | 3075781985 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Frontier Neurosciences, Llc 1008 13th St Suite A Cody WY 82414-3677 Ph: (307) 578-1985 | Frontier Neurosciences, Llc 1008 13th St Suite A Cody WY 82414-3677 Ph: (307) 578-1985 |
| NPI Number | 1124235759 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 09/13/2013 |
| Medicare PECOS PAC ID | 7911800958 |
|---|---|
| Medicare Enrollment ID | O20040128000849 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124235759 | NPI | - | NPPES |
| 116581000 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 6448A (Wyoming) | Primary |
| Provider Name | Allen L Gee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083793863 PECOS PAC ID: 6709789928 Enrollment ID: I20040127000825 |
| Provider Name | Mary Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639263650 PECOS PAC ID: 7810922093 Enrollment ID: I20081201000347 |
| Provider Name | Bradley L Low |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427065739 PECOS PAC ID: 7618977174 Enrollment ID: I20111025000149 |
| Provider Name | Robert Louis Mazzola |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629142898 PECOS PAC ID: 4284691437 Enrollment ID: I20120314000181 |
| Provider Name | Arianne Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225686884 PECOS PAC ID: 4789915083 Enrollment ID: I20191018000020 |
| Provider Name | Diane M Mueller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437185329 PECOS PAC ID: 2062461742 Enrollment ID: I20200325003586 |
| Provider Name | Leslie Epperly Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558097642 PECOS PAC ID: 5799128542 Enrollment ID: I20240208001268 |
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