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424 Yellowstone Ave Suite 120 Cody WY 82414 | |
(307) 578-2907 | |
(307) 587-1256 |
Full Name | |
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Speciality | Clinic/center |
Location | 424 Yellowstone Ave, Cody, Wyoming |
Authorized Official Name and Position | Dougals Alan Mcmillan (CEO) |
Authorized Official Contact | 3075782489 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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707 Sheridan Ave Cody WY 82414 Ph: (307) 578-2480 | 424 Yellowstone Ave Suite 120 Cody WY 82414 Ph: (307) 578-2907 |
NPI Number | 1043200041 |
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Provider Enumeration Date | 10/21/2005 |
Last Update Date | 09/06/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043200041 | NPI | - | NPPES |
106133017 | Medicaid | WY | |
1081001 | Other | WY | BLUE CROSS |
307718 | Other | WY | BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 06-003 (Wyoming) | Primary |
Cody Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2107 Sheridan Avenue, Cody, WY 82414 Phone: 307-586-5303 | |
307 Longevity Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1120 Beck Ave, Cody, WY 82414 Phone: 307-527-0355 Fax: 307-527-0360 | |
Bighorn Valley Health Center, Incorporated Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 902 Blackburn St Ste F, Cody, WY 82414 Phone: 000-000-0000 |