Organization
JASON LOVELL
Active
Other names
Riverton Family Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON DEE LOVELL D.O. (OWNER)
(307) 856-4969
Entity
Organization
Contact information
Practice address
716 COLLEGE VIEW DR, SUITE A, RIVERTON, WY 82501-2282
(307) 857-4969
(307) 856-3883
Mailing address
PO BOX 1783, RIVERTON, WY 82501-0235
(801) 253-4103
(801) 253-0942
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7960A
WY
207R00000X
Internal Medicine Physician
7960A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518268887
—
WY
Enumeration date
11/03/2010
Last updated
05/17/2011
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