Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 128 | WY |
NPI | 1053331504 |
---|---|
Provider Name | Steve E Rabon |
First Address | Sheridan, WY 82801-2186 |
Second Address | Sheridan, WY 82801-2186 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20580 | (02) | WY |
V00198 | (02) | WY |