Provider Demographics
NPI:1639262595
Name:PIERCE, HAROLD L (MD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:L
Last Name:PIERCE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2720 HARNEY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-2899
Mailing Address - Country:US
Mailing Address - Phone:307-745-6065
Mailing Address - Fax:307-745-4936
Practice Address - Street 1:2720 HARNEY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-2899
Practice Address - Country:US
Practice Address - Phone:307-745-6065
Practice Address - Fax:307-745-4936
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2012-10-19
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Provider Licenses
StateLicense IDTaxonomies
WY5981A208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY112600800Medicaid
G50035Medicare UPIN
WY112600800Medicaid
W304155Medicare PIN