Organization
SUMMIT MEMORIAL MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CUSSINS (CFO)
(307) 286-6738
Entity
Organization
Contact information
Practice address
6500 E 2ND ST, CASPER, WY 82609-4338
(307) 577-1000
Mailing address
222 S 5TH ST, DOUGLAS, WY 82633-2534
(307) 358-1459
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
10/16/2024
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