Organization

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)

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

Provider Address