Richard E Jay, D.O.

Individual provider Active NPI Family Medicine Physician · Lovell, WY

NPI 1467470732 · NPPES record last updated Jul 11, 2016

Key facts

NPI
1467470732
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
8882A (WY)
Practice address
1115 Lane 12
North Big Horn Hospital Clinic
Lovell, WY 82431-9537
Phone
(307) 548-5201
Fax
(307) 548-5224
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
111NEMDClinical Psychologist
8882AWYMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8882A WY Yes

Addresses

Primary practice location

1115 Lane 12
North Big Horn Hospital Clinic
Lovell, WY 82431-9537

Mailing address

1115 Lane 12
North Big Horn Hospital Clinic
Lovell, WY 82431-9537
Phone (307) 548-5201

Other providers in Lovell, WY

All providers in Lovell, WY · Family Medicine Physician in Wyoming

Sources for this page

Verify at the official NPI Registry.