Organization Name: | CHEYENNE RADIOLOGY GROUP |
NPI Number: | 1023056082 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID HAID (ADMINISTRATOR) |
Mailing Address: | 2003 Bluegrass Cir Cheyenne |
State: | WY US |
Postal Code: | 820097329 |
Phone Number: | 3076347711 |
Fax Number: | 3076344167 |
NPI Enumeration Date: | 06/03/2006 |
NPI Last Update Date: | 08/10/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |