Provider Demographics
NPI:1124516943
Name:ZACHARY M OSWALD PLLC
Entity type:Organization
Organization Name:ZACHARY M OSWALD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:MCLEAN
Authorized Official - Last Name:OSWALD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:541-699-8595
Mailing Address - Street 1:25 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-3323
Mailing Address - Country:US
Mailing Address - Phone:406-683-2020
Mailing Address - Fax:406-683-6409
Practice Address - Street 1:25 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725
Practice Address - Country:US
Practice Address - Phone:406-683-2020
Practice Address - Fax:406-683-6409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-26
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTOPT-OPT-LIC-3096152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty