| John P Thalken, MD | |
|
111 S 5th St, Douglas, WY 82633-2434 | |
| (307) 358-2122 | |
| (307) 358-9216 |
| Full Name | John P Thalken |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Location | 111 S 5th St, Douglas, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912007212 | NPI | - | NPPES |
| 312719 | Other | WY | BCBS OF WYOMING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 3634A (Wyoming) | Primary |
| Entity Name | Memorial Hospital Of Converse County |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356496491 PECOS PAC ID: 2264340843 Enrollment ID: O20031203000672 |
| Entity Name | Memorial Hospital Of Converse County |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1326085408 PECOS PAC ID: 2264340843 Enrollment ID: O20070815000252 |
| Mailing Address | Practice Location Address |
|---|---|
| John P Thalken, MD 111 S 5th St, Douglas, WY 82633-2434 Ph: (307) 358-2122 | John P Thalken, MD 111 S 5th St, Douglas, WY 82633-2434 Ph: (307) 358-2122 |
Rita Marie Emch, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 111 S 5th St, Douglas, WY 82633 Phone: 307-358-7300 | |
Michelle Neice, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 700 E Center St, Douglas, WY 82633 Phone: 307-358-7300 Fax: 307-358-0831 |