| Dr. Paulus Llc | |
|
1401 Airport Pkwy Ste 100 Cheyenne WY 82001-1522 | |
| (307) 369-2572 | |
| Not Available |
| Full Name | Dr. Paulus Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1401 Airport Pkwy Ste 100, Cheyenne, Wyoming |
| Authorized Official Name and Position | John B Paulus (INTERNIST / OWNER) |
| Authorized Official Contact | 3072210340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Paulus Llc 2533 Moonlight Ct Cheyenne WY 82009-8577 Ph: (307) 221-0340 | Dr. Paulus Llc 1401 Airport Pkwy Ste 100 Cheyenne WY 82001-1522 Ph: (307) 369-2572 |
| NPI Number | 1821779810 |
|---|---|
| Provider Enumeration Date | 07/31/2023 |
| Last Update Date | 07/31/2023 |
| Medicare PECOS PAC ID | 2062867039 |
|---|---|
| Medicare Enrollment ID | O20231011000959 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821779810 | NPI | - | NPPES |
| 1841200797 | Other | NPI FOR DR JOHN B PAULUS | |
| 10750446 | Other | CAQH NUMBER FOR DR. JOHN B PAULUS | |
| 10293A | Other | WY | WYOMING STATE MEDICAL LICENSE OF DR. JOHN B PAULUS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | John B Paulus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841200797 PECOS PAC ID: 1456312792 Enrollment ID: I20151104002674 |
Healthreach Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2030 Bluegrass Cir, Cheyenne, WY 82009 Phone: 307-635-3500 Fax: 307-635-2199 | |
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