| NPI | 1710646344 |
|---|---|
| Other Name | CHEYENNE MEDICAL SPECIALTY CLINIC |
| Entity Type | Organization |
| Authorized Contact | BRAD WHITE Administrator Of Revenue 307-633-6198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2026-07-03 |