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NPI Code Detail

MEDICARE: CHEYENNE OCULAR SURGERY

MEDICARE: CHEYENNE OCULAR SURGERY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center10141WY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326247479
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHEYENNE OCULAR SURGERY
Provider Business Mailing Address
First Line : 1300 E 20TH ST
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-4021
Country : US
Telephone Number : 307-632-2020
Fax Number :
Provider Business Practice Location Address
First Line : 1300 E 20TH ST
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-4021
Country : US
Telephone Number : 307-632-2020
Fax Number :
Authorized Official
Title or Position : VP REVENUE CYCLE MANAGEMENT
Name : LAURA M GARCIA
Credential :
Telephone Number : 949-615-9288
Provider Enumeration Date : 07/17/2007
Last Update Date : 12/12/2025

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1730182239 — DR. RANDOLPH LEIGH JOHNSTON M.D.
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1073516571 — SHAUNA K MCKUSKER M.D.
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Directions to “CHEYENNE OCULAR SURGERY ” Practice Location

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