# TETON COUNTY HOSPITAL DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St Johns Medical Center Physician Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457665333
- **Authorized official:** JOHN J. KREN (CFO)
- **Authorized official phone:** (307) 739-7526

## Contact information

- **Practice address:** BOX 428 625 E BROADWAY AVE, JACKSON, WY 83001-8642
- **Practice address phone:** (307) 733-3636
- **Practice address fax:** (307) 734-9881
- **Mailing address:** PO BOX 428, JACKSON, WY 83001-0428
- **Mailing address phone:** (307) 739-7250

## Taxonomy

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

## Other

- **Enumeration date:** 08/03/2010
- **Last updated:** 08/14/2013