Provider Demographics
NPI:1588693741
Name:VINGLAS, RICHARD N (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:N
Last Name:VINGLAS
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 1:1450 ELLIS ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-8812
Mailing Address - Country:US
Mailing Address - Phone:406-587-0122
Mailing Address - Fax:406-587-5548
Practice Address - Street 1:1450 ELLIS ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8812
Practice Address - Country:US
Practice Address - Phone:406-587-0122
Practice Address - Fax:406-587-5548
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11050207XS0106X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT11050OtherSTATE LICENSE
MT94486OtherBCBS MT
MT11050OtherSTATE LICENSE
MT000085447Medicare PIN