Provider Demographics
NPI:1376859322
Name:LARAMIE URGENT CARE
Entity Type:Organization
Organization Name:LARAMIE URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:M
Authorized Official - Last Name:KLEPPINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-745-3704
Mailing Address - Street 1:1252 N 22ND ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-5306
Mailing Address - Country:US
Mailing Address - Phone:307-745-3704
Mailing Address - Fax:
Practice Address - Street 1:1252 N 22ND ST UNIT A
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-5306
Practice Address - Country:US
Practice Address - Phone:307-460-2305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LARAMIE PEDIATRICS INTERNAL MEDICINE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY124413200Medicaid
WYW20493Medicare PIN