Organization · Type 2 NPI

Teton County Hospital District

General Practice Physician · Jackson, WY

NPI number 1487818605 Active

Practice location

625 E Broadway Ave
Jackson, WY 83001-8642

Call (307) 733-3636 Map

Fax (877) 205-2024

Mailing address

PO Box 428
Jackson, WY 83001-0428

Specialties and licenses

Taxonomy	Code	License
General Practice Physician Primary	208D00000X	15109 (WY)
Rehabilitation Hospital Unit	273Y00000X	None listed

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

56 other providers at this address

Other general practice physician providers in Jackson

Teton County Hospital DistrictGeneral Practice Physician Jackson, WY NPI 1457665333

See all in Jackson →

NPI record

NPI: 1487818605
Entity type: Organization (Type 2)
Issued: Jul 16, 2008
Last updated: Jan 3, 2026
Status: Active
Subpart: Yes of Teton County Hospital District

Other names

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ST John's Health · doing business as
ST John's Medical Center · doing business as

Authorized official

Mitchell C Watson
Chief Financial Officer
(307) 739-7526

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 1487818605

Teton County Hospital District's National Provider Identifier is 1487818605, issued on Jul 16, 2008. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Jackson, WY. The record was last updated on Jan 3, 2026.