Big Horn Basin Childrens Clinic PC
Organization Active NPI Pediatrics Physician · Cody, WY
NPI 1629304589 · NPPES record last updated Mar 13, 2018
Key facts
- NPI
- 1629304589
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 4038A (WY)
- Legal business name
- BIG HORN BASIN CHILDRENS CLINIC PC
- Practice address
- 1220 Sunshine Ave Suite 101
Cody, WY 82414 - Phone
- (307) 587-5545
- Fax
- (307) 527-5202
- NPI assigned
- Oct 28, 2009
- Organization subpart
- No
Authorized official
- Name
- Robert Neil Treece, M.D.
- Title
- Owner
- Phone
- (307) 587-5545
Practitioners 2
-
Peter Damian Sidor, M.D.
-
Lindsey M. Bellamy, D.O.
National Provider Directory
Locations
1220 Sunshine Ave
Ste 101
Cody, WY 82414
Phone (307) 527-7561
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | 4038A | WY | Yes |
Addresses
Primary practice location
1220 Sunshine Ave Suite 101
Cody, WY 82414
Mailing address
1220 Sunshine Ave
Suite 101
Cody, WY 82414-4234
Phone (307) 587-5545
Other providers in Cody, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.