Organization
OUTPATIENT RADIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY RHEA M.D. (PRESIDENT)
(307) 265-1620
Entity
Organization
Contact information
Practice address
419 SOUTH WASHINGTON STREET, SUITE 101, CASPER, WY 82601
(307) 234-6963
(307) 237-1074
Mailing address
419 SOUTH WASHINGTON STREET, SUITE 101, CASPER, WY 82601
(307) 234-6963
(307) 237-1074
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025260001
—
NE
05
—
116358200
—
WY
Enumeration date
03/20/2006
Last updated
06/17/2024
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