Provider Demographics
NPI:1285805770
Name:J. SLOAN HALES M.D.
Entity type:Organization
Organization Name:J. SLOAN HALES M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:SLOAN
Authorized Official - Last Name:HALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-637-5337
Mailing Address - Street 1:1920 EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3716
Mailing Address - Country:US
Mailing Address - Phone:307-637-5337
Mailing Address - Fax:307-637-4525
Practice Address - Street 1:214 E 23RD ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3748
Practice Address - Country:US
Practice Address - Phone:307-633-7823
Practice Address - Fax:307-633-7818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYW307417Medicare PIN