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General NPI Number Information
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NPI Number | 1023912052
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Entity Type | Organization
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Legal Business Name | BIGHORN VALLEY HEALTH CENTER INCORPORATED
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 407 S MEDICAL ARTS CT STE D
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City | GILLETTE
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State | WY
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Zip | 82716-3372
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Country | US
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Telephone | 406-665-4103
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Fax |
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Provider Business Mailing Address
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Address Line | 207 W MAIN ST STE 5
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City | LEWISTOWN
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State | MT
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Zip | 59457-2718
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Country | US
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Telephone | 406-535-6545
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID ANDREW MARK
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Credential | MD
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Telephone | 406-665-4103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | NULL
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