Healthcare Provider Details

I. General information

NPI: 1720310709
Provider Name (Legal Business Name): EMERGENCY MEDICAL PHYSICIANS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2010
Last Update Date: 03/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 E 2ND ST
CASPER WY
82601-2926
US

IV. Provider business mailing address

PO BOX 50770
CASPER WY
82605-0770
US

V. Phone/Fax

Practice location:
  • Phone: 307-333-6910
  • Fax: 307-333-6912
Mailing address:
  • Phone: 307-333-6910
  • Fax: 307-333-6912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DARLENE CROSS
Title or Position: ACCOUNTANT
Credential:
Phone: 307-333-6910