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General NPI Number Information
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NPI Number | 1184135352
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VIEW PHYSICIANS, LLC
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Dates
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Enumeration Date | 10/16/2017
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Last Update Date | 10/16/2017
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Provider Practice Location Address
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Address Line | 2710 HARNEY ST STE 100
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City | LARAMIE
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State | WY
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Zip | 82072-0001
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Country | US
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Telephone | 307-742-9116
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Fax | 307-745-8167
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Provider Business Mailing Address
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Address Line | 2710 HARNEY ST STE 100
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City | LARAMIE
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State | WY
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Zip | 82072-0001
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Country | US
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Telephone | 307-742-9116
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Fax | 307-745-8167
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. JOHN D BRAGG
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Credential | MD
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Telephone | 307-742-9116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State | WY
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | WY
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