Cesko Family Practice Pc | |
819 W Maple St Rawlins WY 82301-5462 | |
(307) 324-3667 | |
(307) 324-5591 |
Full Name | Cesko Family Practice Pc |
---|---|
Speciality | Family Medicine |
Location | 819 W Maple St, Rawlins, Wyoming |
Authorized Official Name and Position | David R Cesko (OWNER) |
Authorized Official Contact | 3073243667 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Cesko Family Practice Pc Po Box 40 Rawlins WY 82301-0040 Ph: (307) 324-3667 | Cesko Family Practice Pc 819 W Maple St Rawlins WY 82301-5462 Ph: (307) 324-3667 |
NPI Number | 1366621476 |
---|---|
Provider Enumeration Date | 10/25/2007 |
Last Update Date | 11/13/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366621476 | NPI | - | NPPES |
112705500 | Medicaid | WY | |
DD4463 | Other | WY | PALMETTO ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 5910A (Wyoming) | Primary |
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