Joseph Anthony Sorge

Individual provider Active NPI Clinical Genetics (M.D.) Physician · Wilson, WY

NPI 1902307952 · NPPES record last updated Feb 26, 2018

Key facts

NPI
1902307952
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Genetics (M.D.) Physician 207SG0201X
License
G49614 (CA)
Practice address
5320 Pine Meadow Road
Wilson, WY 83014
Phone
(307) 739-8990
Fax
(307) 739-8992
NPI assigned
Feb 26, 2018
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
G49614CAMDClinical Genetics (M.D.) Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X G49614 CA Yes

Addresses

Primary practice location

5320 Pine Meadow Road
Wilson, WY 83014

Mailing address

PO Box 11480
Jackson, WY 83002-1480
Phone (307) 739-8990

Other providers in Wilson, WY

All providers in Wilson, WY · Clinical Genetics (M.D.) Physician in Wyoming

Sources for this page

Verify at the official NPI Registry.