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General NPI Number Information
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NPI Number | 1932533619
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Entity Type | Organization
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Legal Business Name | REGIONAL HEALTH PHYSICIANS, INC.
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Dates
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Enumeration Date | 08/29/2013
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Last Update Date | 04/30/2014
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Provider Practice Location Address
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Address Line | 717 PINE STREET
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City | UPTON
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State | WY
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Zip | 82730
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Country | US
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Telephone | 307-746-3582
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Fax |
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Provider Business Mailing Address
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Address Line | 353 FAIRMONT BLVD
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City | RAPID CITY
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State | SD
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Zip | 57701-7375
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Country | US
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Telephone | 605-755-9042
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Fax | 605-755-9040
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | JOHN Y PIERCE
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Credential |
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Telephone | 605-755-9042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2919A
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License Number State | WY
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