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CAMP COUNTY MEM HOSPITAL - PHYSICIAN GROUP NPI 1063575611


NPI Information

NPI: 1063575611
Provider Name: CAMP COUNTY MEM HOSPITAL - PHYSICIAN GROUP
Classification: Emergency Medicine - 207P00000X
Entity Type: Organization
Address:
501 S BURMA AVE
GILLETTE, WY
ZIP 82716
Phone: (307) 688-1415
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CAMP COUNTY MEM HOSPITAL - PHYSICIAN GROUP is an emergency medicine in Gillette, WY. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. CAMP COUNTY MEM HOSPITAL - PHYSICIAN GROUP NPI is 1063575611. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

501 S BURMA AVE
GILLETTE, WY
ZIP 82716-426
Phone: (307) 688-1415
Fax: (307) 688-1420

The provider's authorized official is William A Fitzgerald .
The authorized official title is Executive Vice President and has the following contact phone number (307) 688-1520.

The enumeration date for this NPI number is 12/18/2006 and was last updated on 9/20/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208M00000XHospitalist08-183WYOMINGNo
2207RH0003XInternal MedicineHematology & Oncology08-183WYOMINGNo
32084P0800XPsychiatry & NeurologyPsychiatry08-183WYOMINGNo
42085R0001XRadiologyRadiation Oncology08-183WYOMINGNo
5207P00000XEmergency Medicine08-183WYOMINGYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W4251309MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.