Bear River Urology, LLC
Organization Active NPI Urology Physician · Evanston, WY
NPI 1063708592 · NPPES record last updated Jun 23, 2011
Key facts
- NPI
- 1063708592
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urology Physician 208800000X
- License
- TL#1572 (WY)
- Legal business name
- BEAR RIVER UROLOGY, LLC
- Practice address
- 196 Arrowhead Dr
Suite #4
Evanston, WY 82930-8752 - Phone
- (307) 789-8721
- NPI assigned
- Jun 23, 2011
- Organization subpart
- No
Authorized official
- Name
- Michael E Van Bibber, MD
- Title
- Owner
- Phone
- (801) 821-6717
National Provider Directory
Locations
196 Arrowhead Dr
Ste 4
Evanston, WY 82930
Phone (307) 783-8190
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician |
208800000X | TL#1572 | WY | Yes |
Addresses
Primary practice location
196 Arrowhead Dr
Suite #4
Evanston, WY 82930-8752
Mailing address
196 Arrowhead Dr
Suite #4
Evanston, WY 82930-8752
Phone (307) 789-8721
Other providers in Evanston, WY
- Hannah Bassett
- Jennifer Beagley
- Bear Lake Community Health Center, Inc.
- Bear River Dental
- Bear River Surgical Clinic Inc
- Kimberly Anne Begalla
- Wayne A Bell
- Bellkins Paps
- James David Benson
- Linda Benson
All providers in Evanston, WY · Urology Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.