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Brent Blue, MD
Family Medicine Physician in Jackson, Wyoming
NPI 1063467538

Brent Blue is a Family Medicine Physician based in Jackson, WY. Brent Blue practices in Jackson, WY and has the professional credentials of MD. The NPI Number for Brent Blue is 1063467538 and holds a License No. A31472 (Wyoming).

The current practice location address for Brent Blue is 555 E Broadway Ave Ste 207, Jackson, WY and can be reached out via phone at 307-733-8002 and via fax at 307-739-4811. You can also correspond with Brent Blue through the mailing address at PO BOX 428, JACKSON, WY - 83001-0428 (mailing address contact number: 307-733-8002).

Location: 555 E Broadway Ave Ste 207, Jackson, WY, 83001-0428
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063467538
Provider Name
Brent Blue
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
555 E Broadway Ave Ste 207, Jackson, WY, 83001-0428
Phone Number
307-733-8002
Fax Number
307-739-4811
Provider Enumeration Date
05/23/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
102017000 05 WY
institution
Provider Business Practice Location Address Details
Address
555 E Broadway Ave Ste 207
City
Jackson
State
Wyoming
Zip
83001-8640
Phone Number
307-733-8002
Fax Number
307-739-4811
person
Provider Business Mailing Address Details
Address
Po Box 428
City
Jackson
State
Wyoming
Zip
83001-0428
Phone Number
307-733-8002
Fax Number
307-733-0032
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Emergency Medicine
Speciality
-
Taxonomy
207P00000X
License No.
3416A (Wyoming)
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
3416A (Wyoming)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Urgent Care
Taxonomy
261QU0200X
License No.
A31472 (California)
Definition
Definition to come...
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