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General NPI Number Information
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NPI Number | 1033479977
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Entity Type | Organization
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Legal Business Name | TOWN OF MIDWEST
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Dates
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Enumeration Date | 05/25/2012
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Last Update Date | 05/25/2012
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Provider Practice Location Address
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Address Line | 531 PEAKE STREET
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City | MIDWEST
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State | WY
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Zip | 82643-0190
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Country | US
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Telephone | 307-437-6513
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Fax | 307-437-6514
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Provider Business Mailing Address
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Address Line | PO BOX 190
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City | MIDWEST
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State | WY
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Zip | 82643-0190
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Country | US
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Telephone | 307-437-6513
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Fax | 307-437-6514
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RAZI SAYDJARI
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Credential | M.D.
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Telephone | 307-437-6513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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