THUNDER BASIN ORTHOPAEDICS AND SPORTS MEDICINE PC – Orthopaedic Surgery Physician, NPI 1104883461
Orthopaedic Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for THUNDER BASIN ORTHOPAEDICS AND SPORTS MEDICINE PC
PO BOX 688
DOUGLAS, WY 826330688
Phone: (307) 358-6200
Fax: (307) 358-3748
Type: Mailing
111 S 5TH ST
DOUGLAS, WY 826332434
Phone: (307) 358-6200
Fax: (307) 358-3748
Type: Location
808, South Riverbend Drive, Douglas, Converse County, Wyoming, 82633, United States
DOUGLAS, WY 826332054
Phone: (307) 358-6200
Fax: (307) 358-3748
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-10-01
PECOS data refreshed: 2026-05-27
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 82633)
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