NPI 1366989014 · live from the CMS NPI Registry
Evanston Hospital Corporation
Family Medicine in Lyman, WY. National Provider Identifier 1366989014, active.
NPI record
| NPI | 1366989014 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 107 N Main St., Lyman, WY 82937 |
| Practice phone | 307-787-3313 |
| Mailing address | Po Box 5009, Brentwood, TN 37024 |
| Enumerated | January 19, 2017 |
| Last updated | September 20, 2018 |
| Authorized official | Jeremy Davis, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.