Provider Demographics
NPI:1134151913
Name:INPATIENT CONSULTANTS OF WYOMING LLC
Entity type:Organization
Organization Name:INPATIENT CONSULTANTS OF WYOMING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:STULL
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:720-524-1550
Mailing Address - Street 1:214 EAST 23RD STREET
Mailing Address - Street 2:SUITE 4111
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3748
Mailing Address - Country:US
Mailing Address - Phone:720-524-1550
Mailing Address - Fax:720-524-1551
Practice Address - Street 1:214 EAST 23RD STREET
Practice Address - Street 2:SUITE 4111
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3748
Practice Address - Country:US
Practice Address - Phone:720-524-1550
Practice Address - Fax:720-524-1551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1134151913OtherGROUP NPI NUMBER
WYCH3389OtherGROUP RAILROAD MEDICARE
WY=========OtherGROUP TAX ID NUMBER
WY20907Medicare ID - Type UnspecifiedGROUP MEDICARE PROVIDER #