Provider Demographics
NPI:1457544199
Name:OCHILTREE, ANDREW JAMES (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JAMES
Last Name:OCHILTREE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-3912
Mailing Address - Country:US
Mailing Address - Phone:307-237-8713
Mailing Address - Fax:307-237-5740
Practice Address - Street 1:1328 E 12TH ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-3912
Practice Address - Country:US
Practice Address - Phone:307-237-8713
Practice Address - Fax:307-237-5740
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY314T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY410036494OtherRAILROAD MEDICARE
WY1457544199Medicaid
WY410036494OtherRAILROAD MEDICARE
WY1457544199Medicaid
WY5664040001Medicare NSC