Provider Demographics
NPI:1376686329
Name:GARCIA, JOSEPH RAMON (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:RAMON
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 W 5TH ST, STE 110
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-2752
Mailing Address - Country:US
Mailing Address - Phone:307-675-4610
Mailing Address - Fax:307-675-4615
Practice Address - Street 1:1333 W 5TH ST, STE 103
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-2752
Practice Address - Country:US
Practice Address - Phone:307-675-4610
Practice Address - Fax:307-756-4615
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5076207RC0000X
WY8873A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY117478900Medicaid
TX8F8687Medicare PIN