Individual
DR. DOUGLAS REX PHIPPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
745 BUENA VISTA DR, LANDER, WY 82520-3431
(307) 332-2941
(307) 332-2068
Mailing address
745 BUENA VISTA DR, LANDER, WY 82520-3431
(307) 332-2941
(307) 332-2068
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3442A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080035565
MEDICARE RAILROAD RETIREM
—
05
—
104167300
—
WY
01
—
302199
BLUE SHIELD
WY
Enumeration date
10/04/2006
Last updated
07/08/2007
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