Western Wyoming Dermatology & Surgery PC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

7168A Issued in WY

Legal business name

WESTERN WYOMING DERMATOLOGY & SURGERY PC

Practice address

62 Redmond Street
Jackson, WY 83002-7406

Phone

(307) 734-5864

Fax

(307) 734-5866

NPI assigned

Jan 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Christian Brook Anderson, D.O.

Title

Owner, Physician

Phone

(307) 734-5864

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brandon Lynn Miner, D.O

  • MOHS-Micrographic Surgery Physician
  • Idaho Falls, ID
  • NPI 1528279189
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235692800000",
    "number": "1669518668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 7406",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83002",
            "telephone_number": "307-734-5864",
            "fax_number": "307-734-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 REDMOND STREET",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830027406",
            "telephone_number": "307-734-5864",
            "fax_number": "307-734-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN WYOMING DERMATOLOGY & SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2009-02-27",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "BROOK",
        "authorized_official_title_or_position": "OWNER, PHYSICIAN",
        "authorized_official_telephone_number": "307-734-5864",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WY",
            "license": "7168A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madalyn Webb
• Morris Weintraub
• John Michael Wells
• Yvette Werner, LCSW
• Western Medical Equipment, LLC (Western Medical)
• Western Wyoming Pathology, Inc
• Nils Charles Westfall, M.D.
• Meliza Wetzler, MA
• Albert R Wheeler III, MD
• Keri A Wheeler, MD

• MOHS-Micrographic Surgery Physician in Jackson, WY
• Providers in Jackson, WY by specialty
• MOHS-Micrographic Surgery Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.