# MEMORIAL HOSPITAL OF LARAMIE COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cheyenne Regional Medical Center-Hospitalists
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902786676
- **Authorized official:** BRAD WHITE (PROVIDER ENROLLMENT SPECIALIST)
- **Authorized official phone:** (307) 633-6198

## Contact information

- **Practice address:** 214 E 23RD ST, CHEYENNE, WY 82001-3748
- **Practice address phone:** (307) 432-6629
- **Practice address fax:** (307) 996-4525
- **Mailing address:** PO BOX 20970, CHEYENNE, WY 82003-7020
- **Mailing address phone:** (307) 432-6629
- **Mailing address fax:** (307) 996-4525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/04/2025
- **Last updated:** 07/03/2026