Organization
WYOMING HEALTH MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS LARAWAY (CFO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1233 E 2ND ST, CASPER, WY 82601-2926
(800) 822-7201
(307) 577-2203
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
6674A
WY
207R00000X
Internal Medicine Physician
Primary
5491A
WY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
6869A
WY
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
7364A
WY
207RN0300X
Nephrology Physician
8158A
WY
207RP1001X
Pulmonary Disease Physician
8244A
WY
207T00000X
Neurological Surgery Physician
6384A
WY
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
12/03/2008
Last updated
07/13/2022
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