NPI 1164934121 · live from the CMS NPI Registry
Campbell County Hospital District
Internal Medicine, Geriatric Medicine in Gillette, WY. National Provider Identifier 1164934121, active.
NPI record
| NPI | 1164934121 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Geriatric Medicine 207RG0300X |
| Practice location | 501 S Burma Ave, Gillette, WY 82716 |
| Practice phone | 307-688-3636 |
| Mailing address | Po Box 3046, Gillette, WY 82717 |
| Enumerated | October 31, 2017 |
| Last updated | April 3, 2024 |
| Authorized official | Douglas Popp, Chief Financial Officer |
| Other names | Campbell County Medical Group - Geriatric Clinic |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine, Hospice and Palliative Medicine | 207QH0002X | — |
| Internal Medicine, Geriatric Medicine primary | 207RG0300X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.