Jackson Hole Surgery

Surgery Physician · Jackson, WY

Organization Active NPI

NPI number 1437321650

Practice location

555 E. Broadway
Suite 212
Jackson, WY 83001
Phone
(307) 734-1600
Fax
(307) 733-7679

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NPI record

NPI
1437321650
Entity type
Organization (Type 2)
Enumeration date
March 27, 2008
Last updated
March 27, 2008
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Surgery Physician Primary 208600000X 6475A WY

Mailing address

PO Box 12976
Jackson, WY 83002-2976
Phone
(307) 734-1600
Fax
(307) 733-7679

Authorized official

Name
James M. Balliro, M.D.
Title
Owner
Phone
(307) 734-1600

About Jackson Hole Surgery

Jackson Hole Surgery is a healthcare organization registered in the NPI registry with the primary taxonomy Surgery Physician (code 208600000X). The practice location is 555 E. Broadway, Suite 212, Jackson, WY 83001. The NPI number 1437321650 was assigned on March 27, 2008 and the record was last updated on March 27, 2008.

Jackson Hole Surgery lists a license in the registry: #6475A (WY) for Surgery Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is James M. Balliro, M.D., Owner.

Frequently asked questions

What is the NPI number of Jackson Hole Surgery?

The NPI number is 1437321650.

What is the phone number of Jackson Hole Surgery?

The phone number listed for the practice location is (307) 734-1600.

Where is Jackson Hole Surgery located?

555 E. Broadway, Suite 212, Jackson, WY 83001.

What is the taxonomy code for Jackson Hole Surgery?

The primary taxonomy code is 208600000X – Surgery Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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