Healthcare Provider Details

I. General information

NPI: 1316908940
Provider Name (Legal Business Name): CASPER MEDICAL IMAGING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 SOUTH WASHINGTON STREET SUITE 101
CASPER WY
82601
US

IV. Provider business mailing address

419 SOUTH WASHINGTON STREET SUITE 101
CASPER WY
82601
US

V. Phone/Fax

Practice location:
  • Phone: 307-265-1620
  • Fax: 307-237-1074
Mailing address:
  • Phone: 307-265-1620
  • Fax: 307-237-1074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY RHEA
Title or Position: PRESIDENT
Credential: MD
Phone: 307-265-1620