South Lincoln Hospital District
Family Medicine in Evanston, WY. Organization (NPI-2).
NPI number1235503459
StatusActive
Last updated in NPPESMar 3, 2020
Details
- NPI
- 1235503459
- Entity type
- Organization (NPI-2)
- Legal business name
- South Lincoln Hospital District
- Organization subpart
- No
- Enumeration date
- Nov 26, 2015
- Certification date
- Mar 3, 2020
- Last updated
- Mar 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 10314A | WY | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 261Q00000X | Clinic/Center | – | – |
Other names
- Arrowhead Family Medicine (Doing Business As)
Practice location
195 Feather Way Ste 100Evanston, WY 82930-9352
Phone 307-200-9200 · Fax 307-200-4808
Mailing address
195 Feather Way Ste 100Evanston, WY 82930-9352
Phone 307-200-9200 · Fax 307-200-4808
Authorized official
Karl E Sundberg
Ceo
3078774401
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