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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

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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