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NPI Code Detail

MEDICARE: MEDI HORIZONS INC

MEDICARE: MEDI HORIZONS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician
2207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003836834
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDI HORIZONS INC
Provider Business Mailing Address
First Line : PO BOX 20170
Second Line :
City : CHEYENNE
State : WY
Zip : 82003-7004
Country : US
Telephone Number : 307-635-5393
Fax Number : 307-635-2199
Provider Business Practice Location Address
First Line : 2030 BLUEGRASS CIR
Second Line :
City : CHEYENNE
State : WY
Zip : 82009-7328
Country : US
Telephone Number : 307-635-3500
Fax Number : 307-635-2199
Authorized Official
Title or Position : PRESIDENT
Name : ARLISS THOMPSON
Credential : MD
Telephone Number : 307-635-3500
Provider Enumeration Date : 07/21/2006
Last Update Date : 05/20/2014

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Directions to “MEDI HORIZONS INC ” Practice Location

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