NPI 1154836617 · live from the CMS NPI Registry
Cowboy Medical Group PC
Clinic/Center, Rural Health in Worland, WY. National Provider Identifier 1154836617, active.
NPI record
| NPI | 1154836617 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Rural Health 261QR1300X |
| Practice location | 1125 Charles Ave, Worland, WY 82401 |
| Practice phone | 307-347-2449 |
| Enumerated | December 6, 2017 |
| Last updated | January 19, 2018 |
| Authorized official | Wade Bomengen, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine | 207Q00000X | — |
| Clinic/Center, Rural Health primary | 261QR1300X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.