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NPI Code Detail

MEDICARE: DR. MATTHEW REASE MOOG M.D.

MEDICARE: DR. MATTHEW REASE MOOG M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianMD219202OR
2207L00000XAnesthesiology Physician9615MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992794945
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW REASE MOOG M.D.
Provider Business Mailing Address
First Line : PO BOX 514
Second Line :
City : BIG HORN
State : WY
Zip : 82833-0514
Country : US
Telephone Number : 406-599-9561
Fax Number :
Provider Business Practice Location Address
First Line : 1401 W 5TH ST
Second Line :
City : SHERIDAN
State : WY
Zip : 82801-2705
Country : US
Telephone Number : 307-672-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 10/09/2025

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