Organization · Type 2 NPI

Sublette County Hospital District

Family Medicine Physician · Pinedale, WY

NPI number 1104410596 Active

Practice location

625 E Hennick St
Pinedale, WY 82941-5228

Call (307) 367-4133 Map

Fax (307) 459-8576

Mailing address

PO Box 627
Pinedale, WY 82941-0627

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Urgent Care Clinic/Center	261QU0200X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

6 other providers at this address

Other family medicine physician providers in Pinedale

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NPI record

NPI: 1104410596
Entity type: Organization (Type 2)
Issued: Feb 25, 2021
Last updated: Jul 14, 2026
Status: Active

Other names

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Pinedale Medical Clinic · doing business as
Pinedale Medical Clinic · doing business as

Authorized official

Rex Walk
Chief Executive Officer
(307) 367-0150

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104410596

Sublette County Hospital District's National Provider Identifier is 1104410596, issued on Feb 25, 2021. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Pinedale, WY. The record was last updated on Jul 14, 2026.