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NPI Code Detail

MEDICARE: BIG HORN FAMILY MEDICINE

MEDICARE: BIG HORN FAMILY MEDICINE
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
1261QP2300XPrimary Care Clinic/Center28919WY

General Provider Information

NPI Number : 1831450394
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIG HORN FAMILY MEDICINE
Provider Business Mailing Address
First Line : 316 N 10TH ST
Second Line :
City : WORLAND
State : WY
Zip : 82401-2307
Country : US
Telephone Number : 307-347-8885
Fax Number : 307-347-2428
Provider Business Practice Location Address
First Line : 316 N 10TH ST
Second Line :
City : WORLAND
State : WY
Zip : 82401-2307
Country : US
Telephone Number : 307-347-8885
Fax Number : 307-347-2428
Authorized Official
Title or Position : OWNER/OPERATOR
Name : DR. EDWARD ZIMMERMAN
Credential : M.D.
Telephone Number : 307-347-8885
Provider Enumeration Date : 05/31/2012
Last Update Date : 05/31/2012

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Directions to “BIG HORN FAMILY MEDICINE ” Practice Location

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