Evanston Clinic Corp

NPI #1801084926 in Lyman, Wyoming

Provider Information

NPI Number: 1801084926
Entity Type: Organization
Organization Name: Evanston Clinic Corp
Subpart: Yes (part of a larger organization)
Parent Organization: EVANSTON CLINIC CORP
Primary Specialty: Family Medicine
Enumeration Date: Oct 15, 2007
Last Updated: Oct 15, 2007

Practice Location

Address: 107 N MAIN ST
City: Lyman
State: Wyoming
ZIP Code: 82937
Phone: (307) 787-3313

Authorized Official

Name: DEBBIE T BREWER, MBA
Title: DIRECTOR OF PROVIDER ENROLLMENT
Phone: (615) 465-7626

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

Similar Providers

Individual Providers

Provider Name	Specialty	City
Gary Noe, MD	Family Medicine	Lyman	AI Deep Dive
Karrie L Knopf, PA-C	Family Medicine	Evanston	AI Deep Dive
Edmund Nowicki, MD	Family Medicine	Evanston	AI Deep Dive
DR. Susan K. Roberts, M.D.	Family Medicine	Sheridan	AI Deep Dive

Organizations

Provider Name	Specialty	City
Evanston Hospital Corporation	Family Medicine	Lyman	AI Deep Dive

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