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Organization

WYOMING RANGE MEDICAL PC

Active
Other names
RED DESERT INSTA CARE
Organization subpart
No

Provider details

NPI number
Authorized official
KANDACE FERNANDEZ (OFFICE MANAGER)
(307) 382-3064
Entity
Organization

Contact information

Practice address
2761 COMMERCIAL WAY, ROCK SPRINGS, WY 82901-4753
(307) 382-3064
(307) 382-3303
Mailing address
PO BOX 1479, ROCK SPRINGS, WY 82902-1479
(307) 382-3064
(307) 382-3303

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
313591
BLUE CROSS BLUE SHIELD
WY
Enumeration date
10/06/2006
Last updated
09/11/2018
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