Provider Demographics
NPI:1992727903
Name:FELSTET, TOM RUSSELL (OD)
Entity type:Individual
Prefix:DR
First Name:TOM
Middle Name:RUSSELL
Last Name:FELSTET
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4515 RIMROCK RD
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-1414
Mailing Address - Country:US
Mailing Address - Phone:406-698-3476
Mailing Address - Fax:406-534-1866
Practice Address - Street 1:1331 24TH ST W
Practice Address - Street 2:STE B
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3860
Practice Address - Country:US
Practice Address - Phone:406-534-6848
Practice Address - Fax:406-534-1866
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7260152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U94319Medicare UPIN