| Memorial Hospital Of Converse County | |
|
111 S 5th St Douglas WY 82633-2434 | |
| (307) 358-2122 | |
| (307) 358-9216 |
| Full Name | Memorial Hospital Of Converse County |
|---|---|
| Speciality | General Practice |
| Location | 111 S 5th St, Douglas, Wyoming |
| Authorized Official Name and Position | Curt Dugger (CFO) |
| Authorized Official Contact | 3073582122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Hospital Of Converse County Po Box 1450 Douglas WY 82633-1450 Ph: (307) 358-2122 | Memorial Hospital Of Converse County 111 S 5th St Douglas WY 82633-2434 Ph: (307) 358-2122 |
| NPI Number | 1356496491 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2264340843 |
|---|---|
| Medicare Enrollment ID | O20031203000672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356496491 | NPI | - | NPPES |
| 00946001 | Other | WY | BLUE CROSS WY PHYS GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (Wyoming) | Primary |
| Provider Name | Warren A Birch |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467431361 PECOS PAC ID: 6507779634 Enrollment ID: I20031106000105 |
| Provider Name | Tanda E Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053312504 PECOS PAC ID: 6901891860 Enrollment ID: I20040419001421 |
| Provider Name | Twyla M Thalken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306946611 PECOS PAC ID: 5991791410 Enrollment ID: I20040421001056 |
| Provider Name | John P Thalken |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912007212 PECOS PAC ID: 6901893361 Enrollment ID: I20040428000007 |
| Provider Name | Jonathan P Binder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841214954 PECOS PAC ID: 0941291405 Enrollment ID: I20040521001379 |
| Provider Name | Ryan T Clifford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295773505 PECOS PAC ID: 7113810557 Enrollment ID: I20040614001462 |
| Provider Name | Joe K Schoeber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740233071 PECOS PAC ID: 6709775075 Enrollment ID: I20040623000332 |
| Provider Name | Mark G Murphy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134187008 PECOS PAC ID: 6002885340 Enrollment ID: I20041004000144 |
| Provider Name | Angelo Mario Santiago |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598792483 PECOS PAC ID: 0749249860 Enrollment ID: I20041006000204 |
| Provider Name | Patrick A Robertson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194715037 PECOS PAC ID: 5193623072 Enrollment ID: I20041006000474 |
| Provider Name | Sean E Beyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700809209 PECOS PAC ID: 6305805854 Enrollment ID: I20041008000992 |
| Provider Name | Loren B Thiel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063503514 PECOS PAC ID: 0042205718 Enrollment ID: I20041108000211 |
| Provider Name | Mohammed Majeed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598854671 PECOS PAC ID: 2567413164 Enrollment ID: I20050201000423 |
| Provider Name | Joseph E Mickelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467448043 PECOS PAC ID: 2668365008 Enrollment ID: I20050822000307 |
| Provider Name | William L White |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457461774 PECOS PAC ID: 7214952282 Enrollment ID: I20051008000194 |
| Provider Name | Patrick A Yost |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932122793 PECOS PAC ID: 4688693815 Enrollment ID: I20051117000133 |
| Provider Name | Derek H Gilbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477665925 PECOS PAC ID: 6305815317 Enrollment ID: I20060302000595 |
| Provider Name | Jonathan L Grosdidier |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992808398 PECOS PAC ID: 0749240810 Enrollment ID: I20060314000095 |
| Provider Name | Sherrill A Fox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124034566 PECOS PAC ID: 0345244851 Enrollment ID: I20060913000619 |
| Provider Name | Charles R Woodruff |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700956877 PECOS PAC ID: 6709786965 Enrollment ID: I20070117000510 |
| Provider Name | Troy E Votruba |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477576874 PECOS PAC ID: 5395842389 Enrollment ID: I20070828000667 |
| Provider Name | Julie A Novick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467525519 PECOS PAC ID: 4284727934 Enrollment ID: I20070911000537 |
| Provider Name | Deanne J Johnson Engle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346433554 PECOS PAC ID: 2769576800 Enrollment ID: I20070919000800 |
| Provider Name | Razi Saydjari |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902880628 PECOS PAC ID: 4385622034 Enrollment ID: I20080905000032 |
| Provider Name | Craig S Capron |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1932118189 PECOS PAC ID: 8224199898 Enrollment ID: I20081202000358 |
| Provider Name | Lonnie A Teague |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336311463 PECOS PAC ID: 9537220801 Enrollment ID: I20081204000589 |
| Provider Name | Geoffrey Sherman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275787087 PECOS PAC ID: 3971665001 Enrollment ID: I20081223000464 |
| Provider Name | Christopher C Brown |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376569202 PECOS PAC ID: 5597779033 Enrollment ID: I20090403000068 |
| Provider Name | Roberto Fars |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417053836 PECOS PAC ID: 5496737926 Enrollment ID: I20090608000176 |
| Provider Name | Dennis S Yutani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568564128 PECOS PAC ID: 6901863232 Enrollment ID: I20100121000437 |
| Provider Name | Brehan A Newell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922335579 PECOS PAC ID: 0840332110 Enrollment ID: I20100126000750 |
| Provider Name | Brian S Retherford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134183080 PECOS PAC ID: 1759329634 Enrollment ID: I20101018001309 |
| Provider Name | Steven J Beer |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1588633291 PECOS PAC ID: 4688745813 Enrollment ID: I20101104000817 |
| Provider Name | Ethan T Oconnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306097928 PECOS PAC ID: 7911193081 Enrollment ID: I20101201000683 |
| Provider Name | Karen A Fagin |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1205026994 PECOS PAC ID: 4385540228 Enrollment ID: I20111018000212 |
| Provider Name | Eric Schubert |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1275594467 PECOS PAC ID: 6901808054 Enrollment ID: I20111116000964 |
| Provider Name | Michael Ryan Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336419969 PECOS PAC ID: 1557522687 Enrollment ID: I20120926000809 |
| Provider Name | Peggy D Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245455286 PECOS PAC ID: 0143479923 Enrollment ID: I20121011000537 |
| Provider Name | Kenneth John Whipple |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922040807 PECOS PAC ID: 0345331591 Enrollment ID: I20130924000377 |
| Provider Name | Timothy E Olson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699099143 PECOS PAC ID: 3678707189 Enrollment ID: I20131015001999 |
| Provider Name | Mark S Campbell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770571432 PECOS PAC ID: 6800893678 Enrollment ID: I20131203002085 |
| Provider Name | David Fairbanks |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700989969 PECOS PAC ID: 8325028830 Enrollment ID: I20140129000776 |
| Provider Name | Douglas Wesley White |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538140322 PECOS PAC ID: 7012055973 Enrollment ID: I20140214001636 |
| Provider Name | Ryan S Benson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023308491 PECOS PAC ID: 9234384041 Enrollment ID: I20140708001799 |
| Provider Name | Kathryn A Skuza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780698332 PECOS PAC ID: 0648171660 Enrollment ID: I20140724001151 |
| Provider Name | David B Tarullo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295034874 PECOS PAC ID: 1850519653 Enrollment ID: I20140819002819 |
| Provider Name | Francis A Lansang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346391927 PECOS PAC ID: 3678672292 Enrollment ID: I20141021003241 |
| Provider Name | Philip Najm |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336341312 PECOS PAC ID: 6204904725 Enrollment ID: I20150101000006 |
| Provider Name | Casey M Starks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316205677 PECOS PAC ID: 7517100456 Enrollment ID: I20150917002771 |
| Provider Name | Kerry K Fischer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437522125 PECOS PAC ID: 7012217557 Enrollment ID: I20151204001554 |
| Provider Name | Ashley M Littleton |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1538332820 PECOS PAC ID: 0648343855 Enrollment ID: I20160223001436 |
| Provider Name | Sarah L Frank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619330149 PECOS PAC ID: 3173812542 Enrollment ID: I20160525001912 |
| Provider Name | Keith T Borg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316042518 PECOS PAC ID: 6901798578 Enrollment ID: I20161027000905 |
| Provider Name | Marisa Laurora |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1811948102 PECOS PAC ID: 4587624937 Enrollment ID: I20161103001809 |
| Provider Name | Frederick R Freeman |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1720054646 PECOS PAC ID: 5698784429 Enrollment ID: I20161117002079 |
| Provider Name | Jared A Hall |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861745077 PECOS PAC ID: 6507182516 Enrollment ID: I20161219001563 |
| Provider Name | Melissa R Quinn-bulkley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811447956 PECOS PAC ID: 7012298490 Enrollment ID: I20161222001047 |
| Provider Name | David C Kasarda |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568437911 PECOS PAC ID: 1759377070 Enrollment ID: I20170125002732 |
| Provider Name | Temberly Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225406085 PECOS PAC ID: 3678858834 Enrollment ID: I20170330001316 |
| Provider Name | Burk T Young |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1366490963 PECOS PAC ID: 4183666084 Enrollment ID: I20170829003779 |
| Provider Name | Stephen J Pecevich |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194102384 PECOS PAC ID: 6800151366 Enrollment ID: I20180604001732 |
| Provider Name | Regg A Hagge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902850779 PECOS PAC ID: 3375444508 Enrollment ID: I20180626001331 |
| Provider Name | Ashley E Ullrich |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366837627 PECOS PAC ID: 6608162714 Enrollment ID: I20181113003122 |
| Provider Name | James Bruce Odone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104005172 PECOS PAC ID: 2668609926 Enrollment ID: I20181120001891 |
| Provider Name | Aaron Mcclellan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881016822 PECOS PAC ID: 6204067903 Enrollment ID: I20190204001643 |
| Provider Name | Michelle L Neice |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770926909 PECOS PAC ID: 7416191861 Enrollment ID: I20190318002639 |
| Provider Name | Jennifer Keller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639586209 PECOS PAC ID: 4981944923 Enrollment ID: I20190328003023 |
| Provider Name | Toni Marie Harms |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639643216 PECOS PAC ID: 3678815768 Enrollment ID: I20190418002513 |
| Provider Name | Nathan Cook |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912355082 PECOS PAC ID: 0941595128 Enrollment ID: I20190723002328 |
| Provider Name | Sandra Susanne Gebhart |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1164865796 PECOS PAC ID: 1759683527 Enrollment ID: I20190916000544 |
| Provider Name | Sven Markus Hochheimer |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1629089685 PECOS PAC ID: 1557514882 Enrollment ID: I20190917002518 |
| Provider Name | Stefan Yakel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1245678085 PECOS PAC ID: 6608106489 Enrollment ID: I20190920000614 |
| Provider Name | Jennifer Ella Wagy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861042392 PECOS PAC ID: 2567896061 Enrollment ID: I20191216001545 |
| Provider Name | Amanda K Dykes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902447477 PECOS PAC ID: 9032543749 Enrollment ID: I20200103001902 |
| Provider Name | Mark C Drumhiller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629323837 PECOS PAC ID: 3173771912 Enrollment ID: I20200206000541 |
| Provider Name | Sara M Thronburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225662216 PECOS PAC ID: 0840620951 Enrollment ID: I20200413003035 |
| Provider Name | Stefani L. Bissonette |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407200660 PECOS PAC ID: 8527350495 Enrollment ID: I20200805000423 |
| Provider Name | Julie Lynn Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154912012 PECOS PAC ID: 4688082753 Enrollment ID: I20210410000048 |
| Provider Name | David L Ekman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821344490 PECOS PAC ID: 2365754025 Enrollment ID: I20210414000447 |
| Provider Name | Ryker M Kiel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528450327 PECOS PAC ID: 9830434133 Enrollment ID: I20210506001684 |
| Provider Name | Christopher S Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760532634 PECOS PAC ID: 3375629769 Enrollment ID: I20211102002172 |
| Provider Name | Carene Emmett Weinand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407514573 PECOS PAC ID: 7911390695 Enrollment ID: I20220201001061 |
| Provider Name | John A Sielatycki |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629335658 PECOS PAC ID: 2961705546 Enrollment ID: I20220224001550 |
| Provider Name | Trevor W Bush |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942380431 PECOS PAC ID: 1658564463 Enrollment ID: I20220228001980 |
| Provider Name | Mark D Talmage |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114038403 PECOS PAC ID: 7810989365 Enrollment ID: I20220228002596 |
| Provider Name | Kyle Sokol |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699087239 PECOS PAC ID: 4688988314 Enrollment ID: I20220420001452 |
| Provider Name | Mansoor Ahmad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639583321 PECOS PAC ID: 2365747862 Enrollment ID: I20220620001088 |
| Provider Name | Kayla Whitson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700349040 PECOS PAC ID: 8628307733 Enrollment ID: I20220809004038 |
| Provider Name | Keith L Murdock |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1326305509 PECOS PAC ID: 6901112614 Enrollment ID: I20220818002955 |
| Provider Name | Yousuf Ahmed |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609286590 PECOS PAC ID: 1254633605 Enrollment ID: I20221026000302 |
| Provider Name | Joseph Gutman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780633875 PECOS PAC ID: 9234298027 Enrollment ID: I20221026001414 |
| Provider Name | Lisa A Flora |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821059718 PECOS PAC ID: 3577573500 Enrollment ID: I20221109001670 |
| Provider Name | Nicolette C Strand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013484187 PECOS PAC ID: 9335472992 Enrollment ID: I20221114001987 |
| Provider Name | Brendon Gelford |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013992890 PECOS PAC ID: 0941389514 Enrollment ID: I20230103000275 |
| Provider Name | Julie A Query |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275730418 PECOS PAC ID: 5294914826 Enrollment ID: I20230118002838 |
| Provider Name | Johnathon A Berry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801091806 PECOS PAC ID: 6406039130 Enrollment ID: I20230222000694 |
| Provider Name | Robert Redwood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639457740 PECOS PAC ID: 7416181508 Enrollment ID: I20230327001840 |
| Provider Name | Kenneth Rapp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134534548 PECOS PAC ID: 2264700863 Enrollment ID: I20230412000193 |
| Provider Name | Weldon Allen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790306843 PECOS PAC ID: 2163803339 Enrollment ID: I20230421001902 |
| Provider Name | Samuel W Hoppe |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598147274 PECOS PAC ID: 6709196181 Enrollment ID: I20230517002104 |
| Provider Name | Mitchel Cameron Faulkner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851911663 PECOS PAC ID: 4486035979 Enrollment ID: I20230526002411 |
| Provider Name | Ryan T Burke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588835722 PECOS PAC ID: 3971671140 Enrollment ID: I20230620000799 |
| Provider Name | Wendy L Monrad |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134186810 PECOS PAC ID: 3971576943 Enrollment ID: I20230824003649 |
| Provider Name | Dustin Ross Mayne |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780045427 PECOS PAC ID: 3375906191 Enrollment ID: I20230828001106 |
| Provider Name | Scott M Sundheim |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972542181 PECOS PAC ID: 8426025511 Enrollment ID: I20231013002911 |
| Provider Name | Danielle Clarke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861180473 PECOS PAC ID: 5597109454 Enrollment ID: I20240219002626 |
| Provider Name | Marvin Couch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023031861 PECOS PAC ID: 1153352166 Enrollment ID: I20240226001367 |
High Country Behavioral Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1841 Madora Ave, Douglas, WY 82633 Phone: 307-358-2846 Fax: 307-789-4225 | |
High Country Behavioral Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1841 Madora Ave, Douglas, WY 82633 Phone: 307-358-2846 Fax: 307-358-1144 | |
Trailhead Inpatient Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 S 5th St, Douglas, WY 82633 Phone: 307-358-2122 Fax: 800-305-3233 | |
Douglas Med Spa Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 N 3rd St, Douglas, WY 82633 Phone: 307-358-5244 | |
Banner Health Physicians West Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 S 5th St, Douglas, WY 82633 Phone: 307-358-4350 Fax: 307-322-3861 | |
Douglas Medical Skincare & Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 119 N 3rd St, Douglas, WY 82633 Phone: 307-358-5244 |