Mary Widener

NPI #1508164856 in Gillette, Wyoming

Provider Information

NPI Number: 1508164856
Entity Type: Individual
Name: Mary Widener
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Mar 10, 2011
Last Updated: May 24, 2021

Practice Location

Address: 407 S MEDICAL ARTS CT STE F
City: Gillette
State: Wyoming
ZIP Code: 82716-3372
Phone: (307) 688-9255

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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