Provider Demographics
NPI:1972320596
Name:BIG HORN MEDICAL IMAGING CENTER, LLC
Entity type:Organization
Organization Name:BIG HORN MEDICAL IMAGING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:IRVING
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-751-2765
Mailing Address - Street 1:1005 SUGARLAND DR
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-4447
Mailing Address - Country:US
Mailing Address - Phone:307-675-7777
Mailing Address - Fax:307-675-7778
Practice Address - Street 1:2360 WETLANDS DRIVE
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801
Practice Address - Country:US
Practice Address - Phone:307-751-2765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology