Frontier Spine and Orthopedic Surgery, P.C.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

TL4296 Issued in WY

Legal business name

FRONTIER SPINE AND ORTHOPEDIC SURGERY, P.C.

Practice address

4401 College Dr
Rock Springs, WY 82901-3507

Phone

(307) 352-8930

Fax

(307) 352-8947

NPI assigned

Aug 14, 2018

Last updated

Aug 14, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Justin Moroni Dazley, M.D.

Title

Organizer

Phone

(801) 916-0829

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1881174431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 N. 2600 E",
            "city": "FILER",
            "state": "ID",
            "postal_code": "83328",
            "telephone_number": "801-916-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 COLLEGE DR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829013507",
            "telephone_number": "307-352-8930",
            "fax_number": "307-352-8947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTIER SPINE AND ORTHOPEDIC SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "DAZLEY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "MORONI",
        "authorized_official_title_or_position": "ORGANIZER",
        "authorized_official_telephone_number": "801-916-0829",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WY",
            "license": "TL4296",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "WY",
            "license": "TL4296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea French
• Davan French, RBT
• Jessica Lynn Fritzler, PMHNP
• Reana Fritzler
• Ashley Frommherz
• Randy L Fuja, O.D.
• Elizabeth Fuller
• Donna Gab
• Lindsay Paige Gamberg, BSW
• Karla Ruth Gandiaga, PCSW

• Orthopaedic Surgery of the Spine Physician in Rock Springs, WY
• Providers in Rock Springs, WY by specialty
• Orthopaedic Surgery of the Spine Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.