MEDICARE: DOCTRONIC PHYSICIANS GROUP WY, P.C.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	207P00000X	Emergency Medicine Physician
3	207R00000X	Internal Medicine Physician
4	207V00000X	Obstetrics & Gynecology Physician
5	208000000X	Pediatrics Physician
6	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1518815729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTRONIC PHYSICIANS GROUP WY, P.C.

Provider Business Mailing Address
First Line	:	6742 FOREST HILL BLVD STE 283
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33413-3321
Country	:	US
Telephone Number	:	415-340-2274
Fax Number	:	415-621-9221

Provider Business Practice Location Address
First Line	:	140 E BROADWAY AVE STE 25
Second Line	:
City	:	JACKSON
State	:	WY
Zip	:	83001-8632
Country	:	US
Telephone Number	:	415-340-2274
Fax Number	:	415-621-9221

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	THOMAS FOLEY
Credential	:
Telephone Number	:	201-321-9751

Provider Enumeration Date	:	03/21/2026
Last Update Date	:	03/21/2026

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