Individual provider · NPI-1

Dr. Gary Ray Hart, MD

Internal Medicine · Cody, WY

NPI number1427377456
StatusActive
Last updated in NPPESSep 30, 2020

Details

NPI
1427377456
Entity type
Individual (NPI-1)
Name
Dr. Gary Ray Hart
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jun 1, 2010
Certification date
Sep 30, 2020
Last updated
Sep 30, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine10909AWYYes
207R00000X Internal MedicineE4388TX

Practice location

707 Sheridan Ave
Cody, WY 82414

Phone 307-527-7501

Mailing address

707 Sheridan Ave
Cody, WY 82414-3409

Phone 307-527-7501

Other practice locations

3600 Augusta Dr
Pocatello, ID 83204-4476

Phone 208-705-4548

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