| Evanston Clinic Corp | |
|
107 N Main St Lyman WY 82937 | |
| (307) 787-3313 | |
| Not Available |
| Full Name | Evanston Clinic Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 107 N Main St, Lyman, Wyoming |
| Authorized Official Name and Position | Debbie T Brewer (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Contact | 6154657626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evanston Clinic Corp 7100 Commerce Way Suite 180 Brentwood TN 37027-2829 Ph: (615) 465-7626 | Evanston Clinic Corp 107 N Main St Lyman WY 82937 Ph: (307) 787-3313 |
| NPI Number | 1801084926 |
|---|---|
| Provider Enumeration Date | 10/15/2007 |
| Last Update Date | 10/15/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801084926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Wyoming) | Primary |
Evanston Hospital Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 107 N Main Street, Lyman, WY 82937 Phone: 307-787-3313 Fax: 307-787-3312 | |
Evanston Hospital Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 N Main St., Lyman, WY 82937 Phone: 307-787-3313 | |
Prosperity Practice Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 107 E Owen Ave, Lyman, WY 82937 Phone: 307-679-1403 Fax: 307-242-5077 |