Provider Demographics
NPI:1053306662
Name:BARTHOLOMEW, DEAN WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:WAYNE
Last Name:BARTHOLOMEW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1004 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-2249
Mailing Address - Country:US
Mailing Address - Phone:307-710-0152
Mailing Address - Fax:
Practice Address - Street 1:250 N EVARTS ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-2718
Practice Address - Country:US
Practice Address - Phone:307-764-3721
Practice Address - Fax:307-764-1865
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY7067A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine