NPI 1205025624

John L. Roussalis M.D., P.C.

Organisation Plastic Surgery Physician Casper, WY

Practice location

Address: 1129 E 2nd St, Casper, WY 82601-2903
Phone: (307) 234-4585
Fax: (307) 265-7479

Authorised official

Name: John Louis Roussalis
Title: President
Phone: (307) 234-4585

Registered specialties

Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208200000X Licence 7691A (WY)

Other Plastic Surgery providers in Wyoming →

Registry record

NPI: 1205025624
Entity type: Organization
NPI issued: 22 Oct 2007
Record last updated: 7 Sep 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.