Healthcare Provider Details

I. General information

NPI: 1932288560
Provider Name (Legal Business Name): WYOMING RADIOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 S MAIN ST
SHERIDAN WY
82801-4832
US

IV. Provider business mailing address

227 S MAIN ST
SHERIDAN WY
82801-4832
US

V. Phone/Fax

Practice location:
  • Phone: 307-673-9729
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT STEARS
Title or Position: OWNER
Credential: M.D.
Phone: 307-673-9729