# JACQUES D. BEVERIDGE MD

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1669426292
- **Authorized official:** DR. JACQUES D BEVERIDGE MD (PRESIDENT)
- **Authorized official phone:** (307) 332-2223

## Contact information

- **Practice address:** 1460 MAIN ST, SUITE B, LANDER, WY 82520-2657
- **Practice address phone:** (307) 332-2223
- **Mailing address:** 1460 MAIN ST, SUITE B, LANDER, WY 82520-2657
- **Mailing address phone:** (307) 332-2223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 6275A | WY | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 10/24/2007