Evanston Clinic Corp

LBN: Evanston Clinic Corp
Evanston Clinic Corp is an health care organization with primary practice located at 196 Arrowhead Dr Ste 8 , Evanston WY 82930-8752. The organization recently has 9 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Urology, Allopathic & Osteopathic Physicians / General Practice, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Evanston Clinic Corp can be contacted via phone (307) 783-8365, or through Fey, Laura J via phone (615) 221-3641.

Contact Information

Primary practice address
196 Arrowhead Dr Ste 8 Evanston WY 82930-8752
Phone: (307) 783-8365
Fax: (307) 783-8284
Website:
Map and Directions
Authorized official contact:
Name: Fey, Laura J
Phone: (615) 221-3641

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Wyoming
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X Wyoming
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X Wyoming
Allopathic & Osteopathic Physicians / Surgery 208600000X Wyoming
Allopathic & Osteopathic Physicians / Urology 208800000X Wyoming
Allopathic & Osteopathic Physicians / General Practice 208D00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1013916519
LBN Legal business name Evanston Clinic Corp
DBA Doing business as
Authorized official Fey, Laura J
Entity Organization
Organization subpart 1 No
Enumeration date Jul 18th, 2005
Last updated Mar 4th, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013916519 NPPES
Wyoming Other 06159001 BCBS
Wyoming MEDICAID 1013916519 BCBS

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