Provider Demographics
NPI:1194259242
Name:BIG SKY FUNCTIONAL MEDICINE INC.
Entity type:Organization
Organization Name:BIG SKY FUNCTIONAL MEDICINE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMONE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-321-2708
Mailing Address - Street 1:224 GRAND AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-5952
Mailing Address - Country:US
Mailing Address - Phone:406-601-1313
Mailing Address - Fax:
Practice Address - Street 1:224 GRAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-5952
Practice Address - Country:US
Practice Address - Phone:406-601-1313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-16
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1116261QH0100X
261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service