Daza Medical Consulting Service PC

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

8947A Issued in WY

Legal business name

DAZA MEDICAL CONSULTING SERVICE PC

Practice address

400 S 15TH Street
Worland, WY 82401-3531

Phone

(307) 347-3221

NPI assigned

Sep 13, 2012

Last updated

Sep 13, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lori Labrecque

Title

Accts MGR

Phone

(702) 453-3799

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1740530179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 SHADOW RIDGE DRIVE",
            "city": "GERING",
            "state": "NE",
            "postal_code": "69341",
            "telephone_number": "702-453-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 15TH STREET",
            "city": "WORLAND",
            "state": "WY",
            "postal_code": "824013531",
            "telephone_number": "307-347-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAZA MEDICAL CONSULTING SERVICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "LABRECQUE",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "ACCTS MGR",
        "authorized_official_telephone_number": "702-453-3799"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WY",
            "license": "8947A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WY LIC",
            "identifier": "8947A",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hospitalist Physician in Worland, WY
• Providers in Worland, WY by specialty
• Hospitalist Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.