# MEMORIAL HOSPITAL OF CONVERSE COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356496491
- **Authorized official:** MR. CURT DUGGER (CFO)
- **Authorized official phone:** (307) 358-2122

## Contact information

- **Practice address:** 111 S 5TH ST, DOUGLAS, WY 82633-2434
- **Practice address phone:** (307) 358-2122
- **Practice address fax:** (307) 358-9216
- **Mailing address:** PO BOX 1450, DOUGLAS, WY 82633-1450
- **Mailing address phone:** (307) 358-2122
- **Mailing address fax:** (307) 358-9216

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | WY | Yes |

## Other

- **Enumeration date:** 01/25/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00946001 | BLUE CROSS WY PHYS GROUP | WY |