Provider Demographics
NPI:1720189335
Name:EMERY, STEPHEN F (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:F
Last Name:EMERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 LINDSAY LN
Mailing Address - Street 2:STE C
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-4103
Mailing Address - Country:US
Mailing Address - Phone:307-578-1952
Mailing Address - Fax:307-578-1957
Practice Address - Street 1:720 LINDSAY LN
Practice Address - Street 2:STE C
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-4103
Practice Address - Country:US
Practice Address - Phone:307-578-1952
Practice Address - Fax:307-578-1957
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY4460A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY102380200Medicaid
MT91915OtherCARING PROGRAM FOR CHILD
WA140210OtherWORK COMP
WY303054OtherBLUE CROSS BLUE SHIELD
WY303054Medicare ID - Type Unspecified
WY200009942Medicare ID - Type UnspecifiedRAILROAD
MT82144Medicare ID - Type Unspecified
WY102380200Medicaid