Organization
MEMORIAL HOSPITAL OF CARBON COUNTY
Active
Parent organization
MEMORIAL HOSPITAL OF CARBON COUNTY
Other names
Wagon Circle Family Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEMORIAL HOSPITAL OF CARBON COUNTY
Authorized official
MICHELLE KEPLINGER (CFO)
(307) 324-8347
Entity
Organization
Contact information
Practice address
2012 W ELM STREET, RAWLINS, WY 82301
(307) 324-9098
(307) 324-6726
Mailing address
PO BOX 944, RAWLINS, WY 82301-0944
(307) 324-9098
(307) 324-6726
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4625A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05726001
BCBS OF WYOMING
WY
05
—
120726100
—
WY
01
—
DD2243
RR MEDICARE
WY
Enumeration date
02/16/2007
Last updated
06/15/2017
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