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Jackson Hole Medical Clinic, Llc
Allergy Physician in Jackson, Wyoming
NPI 1699817668

Jackson Hole Medical Clinic, Llc is an Allergy Physician based in Jackson, WY and is specialized in Allergy. Jackson Hole Medical Clinic, Llc practices in Jackson, WY. The NPI Number for Jackson Hole Medical Clinic, Llc is 1699817668 and holds a License No. 5551A (Wyoming).

The current practice location address for Jackson Hole Medical Clinic, Llc is 1415 S. Highway 89, Jackson, WY and can be reached out via phone at 307-739-8999.

Location: 1415 S. Highway 89, Jackson, WY, 83002-8640
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1699817668
Provider Name
Jackson Hole Medical Clinic, Llc
Credential
Provider Entity Type
Organization
Address
1415 S. Highway 89, Jackson, WY, 83002-8640
Phone Number
307-739-8999
Fax Number
Provider Enumeration Date
02/13/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1699817668 05 WY
institution
Provider Business Practice Location Address Details
Address
1415 S. Highway 89
City
Jackson
State
Wyoming
Zip
83001
Phone Number
307-739-8999
Fax Number
person
Provider Business Mailing Address Details
Address
1415 S. Highway 89
City
Jackson
State
Wyoming
Zip
83001
Phone Number
307-739-8999
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Allergy & Immunology
Speciality
Allergy
Taxonomy
207KA0200X
License No.
5551A (Wyoming)
Definition
Definition to come...
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