Provider Demographics
NPI:1144101577
Name:MOUNTAIN VIEW COMPREHENSIVE MEDICINE
Entity type:Organization
Organization Name:MOUNTAIN VIEW COMPREHENSIVE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:BASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:307-223-2005
Mailing Address - Street 1:514 E GRAND AVE # 150
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82070-3839
Mailing Address - Country:US
Mailing Address - Phone:307-223-2005
Mailing Address - Fax:307-670-7326
Practice Address - Street 1:1606 ARNOLD ST
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-8128
Practice Address - Country:US
Practice Address - Phone:307-223-2005
Practice Address - Fax:307-670-7326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty