Provider Demographics
NPI:1013008952
Name:BIG SKY WOMEN'S SPECIALISTS
Entity Type:Organization
Organization Name:BIG SKY WOMEN'S SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-587-9788
Mailing Address - Street 1:931 HIGHLAND BLVD
Mailing Address - Street 2:STE 3210
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6911
Mailing Address - Country:US
Mailing Address - Phone:406-587-9788
Mailing Address - Fax:406-587-9691
Practice Address - Street 1:931 HIGHLAND BLVD
Practice Address - Street 2:STE 3210
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6911
Practice Address - Country:US
Practice Address - Phone:406-587-9788
Practice Address - Fax:406-587-9691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10278207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty