Provider Demographics
NPI:1992804843
Name:THOMETZ, ALAN R (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:R
Last Name:THOMETZ
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:PO BOX 35100
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-5100
Mailing Address - Country:US
Mailing Address - Phone:406-238-2500
Mailing Address - Fax:
Practice Address - Street 1:801 N 29TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0905
Practice Address - Country:US
Practice Address - Phone:406-238-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6792207RC0001X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT8HZN67OtherMEDICARE CROW
MT000001211OtherBCBS PIN
MT0011883OtherMDCD PIN
MT8HZP72OtherMEDICARE LG
WY312573OtherBCBS PIN
WY103698000OtherMDCD PIN
MT8HZP80OtherMEDICARE PRYOR
MTE70082Medicare UPIN
MT8HZN67OtherMEDICARE CROW
MT000001211OtherBCBS PIN
MT0011883OtherMDCD PIN
WYW307900Medicare PIN