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General NPI Number Information
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NPI Number | 1346107778
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Entity Type | Organization
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Legal Business Name | DEER VALLEY CLINIC
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 405 W 7TH ST
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City | GORDON
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State | NE
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Zip | 69343-1053
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Country | US
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Telephone | 308-299-8518
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Fax | 949-817-0772
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Provider Business Mailing Address
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Address Line | 405 W 7TH ST
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City | GORDON
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State | NE
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Zip | 69343-1053
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Country | US
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Telephone | 308-299-8518
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Fax | 949-817-0772
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Authorized Official
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Title or Position | OWNER, PHYSICIAN
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Name | DR. ANPO WICAHPI CHARGING THUNDER
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Credential | MD
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Telephone | 308-299-8518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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