Provider Demographics
NPI:1497844450
Name:NORTHERN PLAINS ANESTHESIA ASSOCIATES, P.C.
Entity type:Organization
Organization Name:NORTHERN PLAINS ANESTHESIA ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LOWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-687-7246
Mailing Address - Street 1:PO BOX 3420
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82717-3420
Mailing Address - Country:US
Mailing Address - Phone:307-688-1325
Mailing Address - Fax:307-688-1377
Practice Address - Street 1:501 S BURMA AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3426
Practice Address - Country:US
Practice Address - Phone:307-688-1824
Practice Address - Fax:307-687-7243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYW4110358Medicare PIN
CI9635Medicare PIN