Provider Type Icon

EVANSTON INTERNAL MEDICINE ASSOC. NPI 1619165719


NPI Information

NPI: 1619165719
Provider Name: EVANSTON INTERNAL MEDICINE ASSOC.

Doing Business As: EVANSTON INTERNAL MEDICINE ASSOCIATES

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 53D0520169

Address:
150 ARROWHEAD DR
EVANSTON, WY
ZIP 82930
Phone: (307) 789-0524
Get Directions

EVANSTON INTERNAL MEDICINE ASSOC. is an internal medicine in Evanston, WY. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. EVANSTON INTERNAL MEDICINE ASSOC. NPI is 1619165719. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Evanston Internal Medicine Associates.

The provider's business location address is:

150 ARROWHEAD DR
EVANSTON, WY
ZIP 82930-353
Phone: (307) 789-0524
Fax: (307) 789-6398

The provider's authorized official is Thomas J Simon .
The authorized official title is President and has the following contact phone number (307) 789-0524.

The CLIA number assigned to this NPI record is 53D0520169 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/15/2007 and was last updated on 11/30/2015.


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
1207R00000XInternal Medicine3812AWYOMINGYes

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
1W307866MEDICARE PINWYOMING

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: 4/28/2024

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.