Provider Demographics
NPI:1508823964
Name:ALLEGRETTO, JOSEPH FORREST (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FORREST
Last Name:ALLEGRETTO
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:PO BOX 688
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:WY
Mailing Address - Zip Code:82633-0688
Mailing Address - Country:US
Mailing Address - Phone:307-682-6222
Mailing Address - Fax:307-682-6999
Practice Address - Street 1:2901 POWDER BASIN AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82718-6406
Practice Address - Country:US
Practice Address - Phone:307-682-6222
Practice Address - Fax:307-682-6999
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY5328A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY108910200Medicaid
WYF09427Medicare UPIN
WY108910200Medicaid