Whalio Doctors

NPI 1386144418

Lifesource of North Carolina

Organisation General Practice Physician Cheyenne, WY

Practice location

Address
1208 E Pershing Blvd, Cheyenne, WY 82001-3230
Phone
(910) 742-9243
Fax
(888) 746-1787
Mailing address
PO Box 538622, Atlanta, GA 30353-8622

Authorised official

Name
Peggy Baddour
Title
President/Owner
Phone
(910) 777-9165

Registered specialties (7)

General Practice Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 208D00000X
Clinical Psychologist
Behavioral Health & Social Service Providers Taxonomy 103TC0700X
Clinical Social Worker
Behavioral Health & Social Service Providers Taxonomy 1041C0700X
Family Medicine Physician
Allopathic & Osteopathic Physicians Taxonomy 207Q00000X
Psychiatry Physician
Allopathic & Osteopathic Physicians Taxonomy 2084P0800X
Physician Assistant
Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X
Nurse Practitioner
Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363L00000X

Registry record

NPI
1386144418
Entity type
Organization
NPI issued
15 Feb 2018
Record last updated
25 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.