Healthcare Provider Details

I. General information

NPI: 1669380390
Provider Name (Legal Business Name): MATTHEW MCGEE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 SANDCHERRY WAY
JACKSON WY
83001-6301
US

IV. Provider business mailing address

937 SANDCHERRY WAY
JACKSON WY
83001-6301
US

V. Phone/Fax

Practice location:
  • Phone: 307-413-5689
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number112031
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: