| Evanston Hospital Corporation | |
|
107 N Main St. Lyman WY 82937-0001 | |
| (307) 787-3313 | |
| Not Available |
| Full Name | Evanston Hospital Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 107 N Main St., Lyman, Wyoming |
| Authorized Official Name and Position | Jeremy Davis (CEO) |
| Authorized Official Contact | 3077838255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evanston Hospital Corporation Po Box 5009 Brentwood TN 37024-5009 Ph: (615) 221-1400 | Evanston Hospital Corporation 107 N Main St. Lyman WY 82937-0001 Ph: (307) 787-3313 |
| NPI Number | 1366989014 |
|---|---|
| Provider Enumeration Date | 01/19/2017 |
| Last Update Date | 09/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366989014 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | 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 | |
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 | |
Evanston Clinic Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 N Main St, Lyman, WY 82937 Phone: 307-787-3313 |