Provider Demographics
NPI:1568453421
Name:SATTERFIELD, RORY (MD)
Entity type:Individual
Prefix:
First Name:RORY
Middle Name:
Last Name:SATTERFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 S WASHINGTON ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2991
Mailing Address - Country:US
Mailing Address - Phone:307-265-1620
Mailing Address - Fax:307-237-1074
Practice Address - Street 1:419 S WASHINGTON ST STE 101
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2991
Practice Address - Country:US
Practice Address - Phone:307-265-1620
Practice Address - Fax:307-237-1074
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00486122085R0202X
NECP4632085R0202X
CAG836342085R0202X
WY12437A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G836340Medicaid
CAF75923Medicare UPIN
CA00G836342Medicare PIN