# CHEYENNE REGIONAL PHYSICIANS GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Plastic Reconstructive & Hand Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093474983
- **Authorized official:** BRAD WHITE (ADMINISTRATOR OF REVENUE)
- **Authorized official phone:** (307) 633-6198

## Contact information

- **Practice address:** 2301 HOUSE AVE STE 507, CHEYENNE, WY 82001-3179
- **Practice address phone:** (307) 635-2562
- **Practice address fax:** (307) 638-2074
- **Mailing address:** PO BOX 20970, CHEYENNE, WY 82003-7020
- **Mailing address phone:** (307) 996-4777
- **Mailing address fax:** (307) 773-8013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0105X | Surgery of the Hand (Surgery) Physician | — | NULL | Yes |
| 2086S0105X | Surgery of the Hand (Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2021
- **Last updated:** 07/03/2026