SNAKE RIVER PLASTIC SURGERY LLC


Address: 555 E. Broadway, Suite 212, Jackson, WY 83001
Phone: 3077336077

SNAKE RIVER PLASTIC SURGERY LLC (NPI# 1104137074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104137074
Entity Type Organization
Organization Name SNAKE RIVER PLASTIC SURGERY LLC
Practice Address 555 E. Broadway
Suite 212
Jackson
WY 83001
Mailing Address Po Box 2862
Jackson
WY 83001-2862
Practice Telephone 3077336077
Mailing Telephone 3077336077
Enumeration Date 2010-06-25
Last Update Date 2010-06-25
Authorized Official Name DR. MICHAEL BARRY GELLIS (MEMBER)
Authorized Official Telephone 3077336077
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 174400000X Specialist 2735A WY Other Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
WY NPI TYPE 1 1508997032 01

Office Location

Street Address 555 E. BROADWAY
SUITE 212
City JACKSON
State WY
Zip Code 83001

Providers in the same location

NPI Name Taxonomy Address Enumeration
1023078128 Robert D. Langer Family Medicine 555 E. Broadway, Suite 108, Jackson, WY 83001 2006-03-24
1376787812 Biohealth Inc Clinic/Center 555 E. Broadway, Ste 210, Jackson, WY 83001 2009-04-28
1053554162 Double Rainbow Sciences, LLC Clinic/Center 555 E. Broadway, Suite 108, Jackson, WY 83001 2009-04-20
1437321650 Jackson Hole Surgery Surgery 555 E. Broadway, Suite 212, Jackson, WY 83001 2008-03-27
1427172279 Holly Gail Payne Pediatrics 555 E. Broadway, Suite 211, Jackson, WY 83001 2007-03-19
1750466405 Karin L Klee Pediatrics 555 E. Broadway, Suite 216, Jackson, WY 83001 2006-10-25
1710076849 Joy Lewis Internal Medicine 555 E. Broadway, Suite 216, Jackson, WY 83001 2006-10-12
1972694545 William John Ramsay IIi Specialist 555 E. Broadway, Suite 214, Jackson, WY 83001-4070 2006-09-27

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861006108 Anne Kathleen Milburn Physical Therapist 3620 S Park Drive, Jackson, WY 83001 2020-09-03
1568009637 Katherine Pringle Ford Case Manager/Care Coordinator 2065 E. Limber Pine Road, Jackson, WY 83001 2019-12-07
1043878408 Cossette Burnham Physical Therapist Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 2019-05-31
1982169371 Cynthia Buck Huyffer Social Worker 755a Cache Creek Drive, Jackson, WY 83001 2019-02-10
1093281594 Lara Cilo Speech-Language Pathologist 1300 W. Valley Springs Road, Jackson, WY 83001 2018-10-23
1740776202 Teton Oral and Maxillofacial Surgery Dentist 1160 Alpine Ln Ste 1d, Jackson, WY 83001 2018-07-09
1437642055 Anna Yanchek Physical Therapist 1090 Us- 89, Jackson Hole, WY 83001 2018-06-08
1891200762 Tyler Ross Wright Chiropractor 1325 Us-89, Suite 108, Jackson, WY 83001 2017-12-13
1073027280 Root To Rise Counseling and Consulting, Pllc Social Worker 2033 Dandelion Court, Jackson, WY 83001 2017-11-27
1962923912 Piper Worthington Social Worker 1910 High School Rd, Jackson, WY 83001 2017-06-29
Find all providers in zip 83001

Taxonomy Information

Taxonomy Code 174400000X
Grouping Other Service Providers
Classification Specialist

Taxonomy Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1427656818 Kimaya Jelks Specialist 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 2020-10-16
1396271565 Karlisha Britton Specialist 7 Lakeland Circle, Suite 300, Jackson, MS 39216 2017-05-10
1922545896 Paul Edward Ruttle Specialist 2640 Trader Rd, Jackson, WY 83001-8321 2017-01-30
1780121483 Andrew Callis Specialist 5303 Old Cape Rd E, Jackson, MO 63755-3850 2017-01-19
1538617055 Jonathan Parker Specialist 95 Riverport Dr, Jackson, TN 38301-5748 2016-09-13
1386096600 Miriam Bick Specialist 4 Florida Pl, Jackson, NJ 08527-1816 2016-07-11
1326429572 Alonzo Roberts Specialist 6110 Highway 18 W, Jackson, MS 39209-9322 2015-06-13
1407289275 Andrew Francis Charland Specialist N168w22224 Main St Ste E, Jackson, WI 53037-9321 2013-08-15
1265872501 Robyn Abbott Roberts Specialist 1904 Lakeland Dr, Suite D, Jackson, MS 39216-5038 2013-07-01
1053754580 Massage Revolution Specialist 210 E Capitol St, Ste M-142, Jackson, MS 39201-2306 2013-04-15
Find all providers in JACKSON

Competitor

Search similar providers

City JACKSON
Zip Code 83001

Improve Information

Please comment or provide details below to improve the information on SNAKE RIVER PLASTIC SURGERY LLC.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches