Camp County Mem Hospital - Physician Group
Emergency Medicine Physician in Gillette, WY(View on Map)
Legal Business Name
Camp County Mem Hospital - Physician Group
NPI Number
1063575611
NPI Type
Organization
Enumeration Date
12/18/2006
Specialties
(Taxonomies)Name
Code
207P00000X
207RH0003X
208M00000X
2084P0800X
2085R0001X
Primary Taxonomy
Yes
No
No
No
No
Licenses
State
Wyoming
License Number
08-183
Contact
Information
Purpose
Mailing
Location
Address
501 S BURMA AVE
501 S BURMA AVE
City
Gillette
Gillette
State
WY
WY
Postal Code
82716-3426
82716-3426
Country
US
US
Telephone Number
(307) 688-1415
(307) 688-1415
Authorized Official
Name
William Fitzgerald
Title or Position
EXECUTIVE VICE PRESIDENT
Telephone Number
(307) 688-1520
Identifiers
Identifier
106333201
Identifier State
WY
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/20/2007