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Organization

CHEYENNE REGIONAL PHYSICIANS GROUP, LLC

Active
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Organization

CHEYENNE REGIONAL PHYSICIANS GROUP, LLC

Active
Other names
Cheyenne Medical Specialty Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
BRAD WHITE (ADMINISTRATOR OF REVENUE)
(307) 633-6198
Entity
Organization

Contact information

Practice address
2301 HOUSE AVE STE 201, CHEYENNE, WY 82001-3177
(307) 638-7757
(307) 638-8359
Mailing address
PO BOX 20970, CHEYENNE, WY 82003-7020
(307) 638-7757
(307) 638-8359

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
207R00000X
Internal Medicine Physician
Primary
207RI0200X
Infectious Disease Physician
207RR0500X
Rheumatology Physician
2084N0400X
Neurology Physician
363L00000X
Nurse Practitioner

Other

Enumeration date
12/10/2021
Last updated
07/03/2026
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