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Organization

MEMORIAL HOSPITAL OF LARAMIE COUNTY

Active
Other names
Cheyenne Regional Medical Center-Hospitalists
Organization subpart
No

Provider details

NPI number
Authorized official
BRAD WHITE (PROVIDER ENROLLMENT SPECIALIST)
(307) 633-6198
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
09/04/2025
Last updated
07/03/2026
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