| Family Medical Center | |
|
497 West Lott Buffalo WY 82834-1609 | |
| (307) 684-5521 | |
| (307) 684-5385 |
| Full Name | Family Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 497 West Lott, Buffalo, Wyoming |
| Authorized Official Name and Position | Kent Ward (ADMINISTRATOR) |
| Authorized Official Contact | 3076845521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Center 497 West Lott Buffalo WY 82834-1609 Ph: (307) 684-5521 | Family Medical Center 497 West Lott Buffalo WY 82834-1609 Ph: (307) 684-5521 |
| NPI Number | 1285612317 |
|---|---|
| Provider Enumeration Date | 01/09/2006 |
| Last Update Date | 04/24/2013 |
| Medicare PECOS PAC ID | 1557344371 |
|---|---|
| Medicare Enrollment ID | O20040611000248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285612317 | NPI | - | NPPES |
| 108205100 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Brian M Darnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225016280 PECOS PAC ID: 6507750080 Enrollment ID: I20040214000223 |
| Provider Name | Derek H Gilbert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477665925 PECOS PAC ID: 6305815317 Enrollment ID: I20060302000595 |
| Provider Name | Blaine J Ruby |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912105107 PECOS PAC ID: 9032201025 Enrollment ID: I20070822000926 |
| Provider Name | Mark S Schueler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346228475 PECOS PAC ID: 6901967553 Enrollment ID: I20081202000203 |
| Provider Name | Hermilo Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023096153 PECOS PAC ID: 8325109978 Enrollment ID: I20081202000235 |
| Provider Name | Aubrey D Tabb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316925456 PECOS PAC ID: 3779644331 Enrollment ID: I20081202000251 |
| Provider Name | Lawrence Kirven |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346228483 PECOS PAC ID: 7113088774 Enrollment ID: I20081202000280 |
| Provider Name | Shaun J Gonda |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881810596 PECOS PAC ID: 3476608910 Enrollment ID: I20090904000059 |
| Provider Name | Jennifer Rice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336229624 PECOS PAC ID: 1951490457 Enrollment ID: I20090910000661 |
| Provider Name | Thomas E Radosevich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114969698 PECOS PAC ID: 1557404746 Enrollment ID: I20100210000680 |
| Provider Name | Thomas J Richards |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346389426 PECOS PAC ID: 6800709650 Enrollment ID: I20100921000508 |
| Provider Name | Amber N Kinner |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346400777 PECOS PAC ID: 9133391121 Enrollment ID: I20111018000094 |
| Provider Name | Ryan R Ludwig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962666917 PECOS PAC ID: 9436203098 Enrollment ID: I20120109000415 |
| Provider Name | Gregory G Marino |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1023054285 PECOS PAC ID: 1456401983 Enrollment ID: I20121213000490 |
| Provider Name | Luke A Goddard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821300013 PECOS PAC ID: 5395988067 Enrollment ID: I20130828000167 |
| Provider Name | William B Taylor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447423322 PECOS PAC ID: 1456591015 Enrollment ID: I20140711001687 |
| Provider Name | Lisa M Mullen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629364377 PECOS PAC ID: 9436396272 Enrollment ID: I20140925001204 |
| Provider Name | Erica D Rinker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679860597 PECOS PAC ID: 5597914846 Enrollment ID: I20160915002565 |
| Provider Name | Alyse Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609280486 PECOS PAC ID: 5597074765 Enrollment ID: I20170822002419 |
| Provider Name | Wade W See |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891107314 PECOS PAC ID: 5496084253 Enrollment ID: I20201218002096 |
| Provider Name | Zachary T Carlson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760942387 PECOS PAC ID: 7113346677 Enrollment ID: I20231016000391 |
Johnson County Healthcare Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 497 West Lott, Buffalo, WY 82834 Phone: 307-684-6188 Fax: 307-684-5385 | |
Simply Chiropractic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 950 W Fetterman St, Buffalo, WY 82834 Phone: 307-670-3352 |