# CHEYENNE REGIONAL PHYSICIANS GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cheyenne Children's Clinic (MOB)
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356009294
- **Authorized official:** BRAD WHITE (ADMINISTRATOR OF REVENUE)
- **Authorized official phone:** (307) 633-6198

## Contact information

- **Practice address:** 2301 HOUSE AVE STE 405, CHEYENNE, WY 82001-3180
- **Practice address phone:** (307) 635-7961
- **Practice address fax:** (307) 778-5812
- **Mailing address:** PO BOX 20970, CHEYENNE, WY 82003-7020
- **Mailing address phone:** (307) 635-7961
- **Mailing address fax:** (307) 778-5812

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |

## Other

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