Organization
EVANSTON HOSPITAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY DAVIS (CEO)
(307) 783-8255
Entity
Organization
Contact information
Practice address
107 N MAIN ST., LYMAN, WY 82937-0001
(307) 787-3313
Mailing address
PO BOX 5009, BRENTWOOD, TN 37024-5009
(615) 221-1400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/19/2017
Last updated
09/20/2018
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