Basic Information
| Provider Information | |||||||||
| NPI: | 1710419445 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BIG HORN ANESTHESIA ASSOCIATES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 767 | ||||||||
| Address2: | |||||||||
| City: | SHERIDAN | ||||||||
| State: | WY | ||||||||
| PostalCode: | 828010767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002100500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1401 W 5TH ST | ||||||||
| Address2: | |||||||||
| City: | SHERIDAN | ||||||||
| State: | WY | ||||||||
| PostalCode: | 828012705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3076721000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2017 | ||||||||
| LastUpdateDate: | 03/31/2017 | ||||||||
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| AuthorizedOfficialLastName: | RAMSAY | ||||||||
| AuthorizedOfficialFirstName: | JAMIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3076745123 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.