| Neurology Specialists Of The Rockies, Llc | |
|
2003 Bluegrass Cir Cheyenne WY 82009-7329 | |
| (307) 287-0867 | |
| (307) 635-1875 |
| Full Name | Neurology Specialists Of The Rockies, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2003 Bluegrass Cir, Cheyenne, Wyoming |
| Authorized Official Name and Position | Timothy Jay Allen (OWNER) |
| Authorized Official Contact | 3074323924 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology Specialists Of The Rockies, Llc 2003 Bluegrass Cir Cheyenne WY 82009-7329 Ph: (307) 287-0867 | Neurology Specialists Of The Rockies, Llc 2003 Bluegrass Cir Cheyenne WY 82009-7329 Ph: (307) 287-0867 |
| NPI Number | 1225559339 |
|---|---|
| Provider Enumeration Date | 06/28/2017 |
| Last Update Date | 07/21/2022 |
| Certification Date | 03/04/2021 |
| Medicare PECOS PAC ID | 4587937057 |
|---|---|
| Medicare Enrollment ID | O20170905001723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225559339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 6318A (Wyoming) | Primary |
| 293D00000X | Physiological Laboratory | (* (Not Available)) | Secondary |
| Provider Name | Timothy J Allen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164425898 PECOS PAC ID: 7113814542 Enrollment ID: I20170830001472 |
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