Provider Demographics
NPI:1952596199
Name:GYN CARE, PC
Entity Type:Organization
Organization Name:GYN CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHAMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-637-7886
Mailing Address - Street 1:1616 E 19TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4946
Mailing Address - Country:US
Mailing Address - Phone:307-637-7886
Mailing Address - Fax:307-637-7925
Practice Address - Street 1:1616 E 19TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4946
Practice Address - Country:US
Practice Address - Phone:307-637-7886
Practice Address - Fax:307-637-7925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY5381A207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY308309Medicare PIN
WYDH1480Medicare PIN