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Organization

TETON COUNTY HOSPITAL DISTRICT

Active
Parent organization
TETON COUNTY HOSPITAL DISTRICT
Other names
St Johns Medical Center ER Physicians
Organization subpart
Yes

Provider details

NPI number
Legal business name
TETON COUNTY HOSPITAL DISTRICT
Authorized official
JOHN J. KREN (CFO)
(307) 739-7526
Entity
Organization

Contact information

Practice address
625 E BROADWAY AVE, JACKSON HOLE, WY 83001-8642
(307) 739-7250
(307) 739-7249
Mailing address
PO BOX 428, JACKSON, WY 83001-0428
(307) 739-7250
(307) 739-7249

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
15109
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106299910
WY
Enumeration date
05/20/2010
Last updated
03/16/2016
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