NPI 1801084926 · live from the CMS NPI Registry
Evanston Clinic Corp
Family Medicine in Lyman, WY. National Provider Identifier 1801084926, active.
NPI record
| NPI | 1801084926 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 | 7100 Commerce Way, Suite 180, Brentwood, TN 37027 |
| Enumerated | October 15, 2007 |
| Last updated | October 15, 2007 |
| Authorized official | Debbie Brewer, Director Of Provider Enrollment |
| Other names | Bridger Valley Family Practice |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | — (WY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.