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Organization
MEMORIAL HOSPITAL OF LARAMIE COUNTY
Active
Organization
MEMORIAL HOSPITAL OF LARAMIE COUNTY
Active
Other names
Wound Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD WHITE (ADMINISTRATOR OF REVENUE)
(307) 633-6198
Entity
Organization
Contact information
Practice address
214 E 23RD ST, CHEYENNE, WY 82001-3748
(307) 633-6088
Mailing address
PO BOX 20970, CHEYENNE, WY 82003-7020
(307) 633-6088
(307) 432-3106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
—
—
213E00000X
Podiatrist
—
—
Other
Enumeration date
12/09/2021
Last updated
07/03/2026
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