Organization
MEDI HORIZONS INC
Active
Parent organization
BLUEGRASS PROFESSIONAL PLAZA
Other names
HEALTHREACH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BLUEGRASS PROFESSIONAL PLAZA
Authorized official
ARLISS THOMPSON MD (PRESIDENT)
(307) 635-3500
Entity
Organization
Contact information
Practice address
2030 BLUEGRASS CIR, CHEYENNE, WY 82009-7328
(307) 635-3500
(307) 635-2199
Mailing address
PO BOX 20170, CHEYENNE, WY 82003-7004
(307) 635-5393
(307) 635-2199
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106825300
—
WY
Enumeration date
07/21/2006
Last updated
05/20/2014
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