| Wyoming Neurologic Associates Llc | |
|
1020 E 2nd St Ste 100 Casper WY 82601-2946 | |
| (307) 265-4343 | |
| (307) 234-6339 |
| Full Name | Wyoming Neurologic Associates Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1020 E 2nd St, Casper, Wyoming |
| Authorized Official Name and Position | Jo Depaolo (PRACTICE MANAGER) |
| Authorized Official Contact | 3072654343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyoming Neurologic Associates Llc 1020 E 2nd St Ste 100 Casper WY 82601-2946 Ph: (307) 265-4343 | Wyoming Neurologic Associates Llc 1020 E 2nd St Ste 100 Casper WY 82601-2946 Ph: (307) 265-4343 |
| NPI Number | 1740371145 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 06/15/2011 |
| Medicare PECOS PAC ID | 7315949534 |
|---|---|
| Medicare Enrollment ID | O20070131000746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740371145 | NPI | - | NPPES |
| 121198600 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 7035A (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 | David B Wheeler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013008416 PECOS PAC ID: 7810937141 Enrollment ID: I20050505001165 |
| Provider Name | Mary Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639263650 PECOS PAC ID: 7810922093 Enrollment ID: I20081201000347 |
| Provider Name | Robert Louis Mazzola |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629142898 PECOS PAC ID: 4284691437 Enrollment ID: I20120314000181 |
| Provider Name | Dixie Jean Woolston |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1578889929 PECOS PAC ID: 4385889955 Enrollment ID: I20140821002354 |
| Provider Name | Oliver Jeffery |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083929160 PECOS PAC ID: 9234375189 Enrollment ID: I20141201000961 |
| Provider Name | Glenna Hedrick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881855302 PECOS PAC ID: 7911214457 Enrollment ID: I20150916002451 |
| Provider Name | Anna Parton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578508511 PECOS PAC ID: 4082517065 Enrollment ID: I20160421002423 |
| Provider Name | Tracie Parsell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629588421 PECOS PAC ID: 1658638457 Enrollment ID: I20171204001807 |
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