| Western Trails Family Medicine, Llc | |
|
1463 17th Ave Mitchell NE 69357-1429 | |
| (308) 623-1313 | |
| (308) 623-1313 |
| Full Name | Western Trails Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1463 17th Ave, Mitchell, Nebraska |
| Authorized Official Name and Position | John Wesly Bowlin (PRESIDENT) |
| Authorized Official Contact | 3086231313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Trails Family Medicine, Llc 1463 17th Ave Mitchell NE 69357-1429 Ph: (308) 623-1313 | Western Trails Family Medicine, Llc 1463 17th Ave Mitchell NE 69357-1429 Ph: (308) 623-1313 |
| NPI Number | 1205223740 |
|---|---|
| Provider Enumeration Date | 04/22/2015 |
| Last Update Date | 04/22/2015 |
| Medicare PECOS PAC ID | 2264745637 |
|---|---|
| Medicare Enrollment ID | O20150715000729 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205223740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Steve C Boyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730104886 PECOS PAC ID: 7911087374 Enrollment ID: I20080110000428 |
| Provider Name | Christopher Wiles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104371467 PECOS PAC ID: 3173819968 Enrollment ID: I20160902000729 |
Regional West Physicians Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1456 Center Ave, Mitchell, NE 69357 Phone: 308-623-1234 Fax: 308-623-1388 |