Provider Demographics
NPI:1427648583
Name:MATNEY, SARAH ELIZABETH (RT (R) (CT))
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:MATNEY
Suffix:
Gender:F
Credentials:RT (R) (CT)
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:GROGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RT (R)
Mailing Address - Street 1:4010 RAWLINS ST
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-1935
Mailing Address - Country:US
Mailing Address - Phone:803-983-8085
Mailing Address - Fax:
Practice Address - Street 1:214 E 23RD ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3748
Practice Address - Country:US
Practice Address - Phone:307-634-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYGN-2612-022085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty