Provider Demographics
NPI:1528162070
Name:LARAMIE PHYSICIANS FOR WOMEN PC
Entity type:Organization
Organization Name:LARAMIE PHYSICIANS FOR WOMEN PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:DON
Authorized Official - Last Name:KLINGLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-745-8991
Mailing Address - Street 1:1277 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-2343
Mailing Address - Country:US
Mailing Address - Phone:307-745-8991
Mailing Address - Fax:307-745-8167
Practice Address - Street 1:1277 N 15TH ST
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-2343
Practice Address - Country:US
Practice Address - Phone:307-745-8991
Practice Address - Fax:307-745-8167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYF94358Medicare UPIN
WYI54792Medicare UPIN
WYH43247Medicare UPIN
WYH20126Medicare UPIN
WYP85651Medicare UPIN
WYH75424Medicare UPIN