Basic Information
| Provider Information | |||||||||
| NPI: | 1508936360 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BILLINGS | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | ALAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2510 E 15TH ST | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | CASPER | ||||||||
| State: | WY | ||||||||
| PostalCode: | 826094111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3072349657 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1233 E 2ND ST | ||||||||
| Address2: | WYOMING MEDICAL CENTER | ||||||||
| City: | CASPER | ||||||||
| State: | WY | ||||||||
| PostalCode: | 826012926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3075777201 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2006 | ||||||||
| LastUpdateDate: | 10/10/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 5088A | WY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 050057419 | 01 | WY | RAILROAD MEDICARE | OTHER | 307534 | 01 | WY | BLUE SHIELD | OTHER | 102775100 | 05 | WY | MEDICAID | 050083481 | 01 | RAILROAD MEDICARE | OTHER | 305958 | 01 | BLUE SHIELD | OTHER | W23470 | 01 | WY | MEDICARE PTAN | OTHER |