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General NPI Number Information
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NPI Number | 1275876328
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Entity Type | Organization
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Legal Business Name | WYOMING EM-I MEDICAL SERVICES, P.C.
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Dates
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Enumeration Date | 03/27/2013
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Last Update Date | 03/27/2013
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Provider Practice Location Address
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Address Line | 111 S 5TH ST
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City | DOUGLAS
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State | WY
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Zip | 82633-2434
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Country | US
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Telephone | 307-358-2122
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Fax | 800-305-3233
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Provider Business Mailing Address
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Address Line | 815 S PALAFOX ST 3RD FLOOR
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City | PENSACOLA
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State | FL
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Zip | 32502-5960
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Country | US
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Telephone | 800-444-7009
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Fax | 800-305-3233
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH H GATEWOOD
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Credential | M.D.
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Telephone | 214-712-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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