Provider Demographics
NPI:1063424711
Name:BEARTOOTH VISION CENTER, P.C.
Entity type:Organization
Organization Name:BEARTOOTH VISION CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PEMBROKE
Authorized Official - Last Name:CURRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:406-652-9339
Mailing Address - Street 1:1600 JUDD CIR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6564
Mailing Address - Country:US
Mailing Address - Phone:406-652-9339
Mailing Address - Fax:406-652-4237
Practice Address - Street 1:2499 GABEL RD
Practice Address - Street 2:SUITE 3
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7349
Practice Address - Country:US
Practice Address - Phone:406-652-9339
Practice Address - Fax:406-652-4237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT622152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT6337820001Medicare NSC