Healthcare Provider Details

I. General information

NPI: 1972320596
Provider Name (Legal Business Name): BIG HORN MEDICAL IMAGING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2360 WETLANDS DRIVE
SHERIDAN WY
82801
US

IV. Provider business mailing address

1005 SUGARLAND DR
SHERIDAN WY
82801-4447
US

V. Phone/Fax

Practice location:
  • Phone: 307-751-2765
  • Fax:
Mailing address:
  • Phone: 307-675-7777
  • Fax: 307-675-7778

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: IRVING E ROBINSON
Title or Position: PARTNER
Credential: MD
Phone: 307-751-2765