NPI 1891997151 GRAND TETON MEDICAL CLINIC JACKSON WY. Find Phone Number, Address, Contact details of medical healthcare providers | NPI Number Lookup

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Grand Teton Medical Clinic - NPI: 1891997151

National Provider Identifier (NPI) is a 10-digit identification number which is issued to health care providers by the Centers for Medicare and Medicaid Services (CMS) in the United States(US). The NPI is introduced to replace of UPIN (unique provider identification number) and now NPI is the only required identifier for Medicare services, and NPI is also used by commercial healthcare insurers and by other payers.

Organization Name: GRAND TETON MEDICAL CLINIC
NPI Number: 1891997151
Entity Type Code: Organizational (2)
Authorized Official Name: BRENT BLUE
(CLINIC OWNER)
Mailing Address: Inner Loop Road Jackson Lake Lodge
Moran
State: WY US
Postal Code: 83013
Phone Number: 3075432514
Fax Number: 3075432514
NPI Enumeration Date: 05/31/2007
NPI Last Update Date: 08/02/2007
Replacement NPI: 0
NPI Deactivation Date:
NPI Reactivation Date:

Taxonomy Information:

Healthcare Provider Taxonomy: 261QU0200X
License Number:
Healthcare Provider Taxonomy:
(Secondary)
Y
State:
Taxonomy Type: Ambulatory Health Care Facilities
Taxonomy Classification: Clinic/Center
Taxonomy Specialization: Urgent Care
Taxonomy Definition:


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