Provider Demographics
NPI:1366445926
Name:STEPLOCK, ALBERT LOUIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:LOUIS
Last Name:STEPLOCK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:805 E 2ND ST
Mailing Address - Street 2:STE 3
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2641
Mailing Address - Country:US
Mailing Address - Phone:307-237-2300
Mailing Address - Fax:307-237-1346
Practice Address - Street 1:805 E 2ND ST
Practice Address - Street 2:STE 3
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2641
Practice Address - Country:US
Practice Address - Phone:307-237-2300
Practice Address - Fax:307-237-1346
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY3785A208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY112889200Medicaid
WY060046935OtherRAILROAD MEDICARE
WY307514OtherBLUE SHIELD
WY112889200OtherWYOMING MEDICAID
WY307514OtherBLUE SHIELD
WY309153Medicare ID - Type Unspecified
WY060046935OtherRAILROAD MEDICARE