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Organization
CHEYENNE UROLOGICAL PC
Active
Organization
CHEYENNE UROLOGICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES A LUGG M.D. (PRESIDENT)
(307) 635-4131
Entity
Organization
Contact information
Practice address
2301 HOUSE AVE STE 502, CHEYENNE, WY 82001-3179
(307) 635-4131
(307) 635-4134
Mailing address
2301 HOUSE AVE STE 502, CHEYENNE, WY 82001-3179
(307) 635-4131
(307) 635-4134
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
NULL
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01045001
BCBS OF WYOMING
WY
05
—
110722400
—
WY
01
—
CT1864
RAILROAD MEDICARE
WY
Enumeration date
11/02/2006
Last updated
06/17/2010
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