Provider Demographics
NPI:1720330053
Name:CREGER, JOHN EVERETT (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EVERETT
Last Name:CREGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 E GLENDALE ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-2707
Mailing Address - Country:US
Mailing Address - Phone:406-683-2611
Mailing Address - Fax:
Practice Address - Street 1:233 E GLENDALE ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-2707
Practice Address - Country:US
Practice Address - Phone:406-683-2611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD 60576842152W00000X
MTOPT-OPT-LIC-2475152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist