Individual
MARK MATTHEW NEIMAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
625 E BROADWAY AVE, JACKSON, WY 83001-8642
(307) 733-3636
(888) 329-5701
Mailing address
PO BOX 428, JACKSON, WY 83001-0428
(307) 733-3636
(888) 329-5701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
CDR.3892
CO
207R00000X
Internal Medicine Physician
10289A
WY
207R00000X
Internal Medicine Physician
Primary
13244411-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142001100
—
WY
Enumeration date
07/01/2011
Last updated
04/21/2026
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