Healthcare Provider Details

I. General information

NPI: 1528162070
Provider Name (Legal Business Name): LARAMIE PHYSICIANS FOR WOMEN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1277 N 15TH ST
LARAMIE WY
82072-2343
US

IV. Provider business mailing address

1277 N 15TH ST
LARAMIE WY
82072-2343
US

V. Phone/Fax

Practice location:
  • Phone: 307-745-8991
  • Fax: 307-745-8167
Mailing address:
  • Phone: 307-745-8991
  • Fax: 307-745-8167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TRAVIS DON KLINGLER
Title or Position: OWNER / MEDICAL DIRECTOR
Credential: MD
Phone: 307-745-8991