Provider Demographics
NPI:1760089452
Name:WYOMING MEDICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:WYOMING MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:HUNTER
Authorized Official - Last Name:RINKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-682-9962
Mailing Address - Street 1:6990 US HIGHWAY 14-16
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:WY
Mailing Address - Zip Code:82831-9617
Mailing Address - Country:US
Mailing Address - Phone:307-660-9232
Mailing Address - Fax:
Practice Address - Street 1:940 E 3RD ST STE 210
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-3251
Practice Address - Country:US
Practice Address - Phone:073-264-3087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-06
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center