Healthcare Provider Details

I. General information

NPI: 1730490582
Provider Name (Legal Business Name): COWBOY URGENT CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2010
Last Update Date: 06/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4620 GRANDVIEW AVE SUITE 104
CHEYENNE WY
82009
US

IV. Provider business mailing address

813 HIGHLAND AVE
SHERIDAN WY
82801
US

V. Phone/Fax

Practice location:
  • Phone: 307-673-5501
  • Fax: 307-637-6730
Mailing address:
  • Phone: 307-673-5501
  • Fax: 307-673-5434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHEL SKAF
Title or Position: PRESIDENT AND CEO
Credential: M.D.
Phone: 307-277-3867