Healthcare Provider Details

I. General information

NPI: 1518074442
Provider Name (Legal Business Name): ROBIN C EICHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 E 18TH ST
CHEYENNE WY
82001-5511
US

IV. Provider business mailing address

PO BOX 20970
CHEYENNE WY
82003-7020
US

V. Phone/Fax

Practice location:
  • Phone: 307-633-7370
  • Fax: 307-633-7202
Mailing address:
  • Phone: 307-633-7370
  • Fax: 307-633-7202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberDR33247
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number3757A
License Number StateWY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01332477
Identifier TypeMEDICAID
Identifier StateCO
Identifier Issuer
# 2
Identifier106917900
Identifier TypeMEDICAID
Identifier StateWY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: