Evanston Clinic Corp
LBN: Evanston Clinic Corp
Evanston Clinic Corp is an health care organization with primary practice located at 196 Arrowhead Dr Ste 8 , Evanston WY 82930-8752. The organization recently has 9 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Urology, Allopathic & Osteopathic Physicians / General Practice, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Evanston Clinic Corp can be contacted via phone (307) 783-8365, or through Fey, Laura J via phone (615) 221-3641.
Contact Information
Primary practice address
196 Arrowhead Dr Ste 8
Evanston WY 82930-8752
Phone: (307) 783-8365
Fax: (307) 783-8284
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | Wyoming | |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | Wyoming | |
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | Wyoming | |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | Wyoming | |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | Wyoming | |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X |
Profile Details
| NPI number | 1013916519 |
|---|---|
| LBN Legal business name | Evanston Clinic Corp |
| DBA Doing business as | |
| Authorized official | Fey, Laura J |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 18th, 2005 |
| Last updated | Mar 4th, 2019 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013916519 | NPPES |
| Wyoming | Other | 06159001 | BCBS |
| Wyoming | MEDICAID | 1013916519 | BCBS |
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