Provider Demographics
NPI:1033240775
Name:YELLOWSTONE FOOT & ANKLE PC
Entity Type:Organization
Organization Name:YELLOWSTONE FOOT & ANKLE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCLAWS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:406-252-5444
Mailing Address - Street 1:1139 N 27TH ST
Mailing Address - Street 2:SUITE B1
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0117
Mailing Address - Country:US
Mailing Address - Phone:406-252-5444
Mailing Address - Fax:406-245-9043
Practice Address - Street 1:1139 N 27TH ST
Practice Address - Street 2:SUITE B1
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0117
Practice Address - Country:US
Practice Address - Phone:406-252-5444
Practice Address - Fax:406-245-9043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT165213ES0103X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000083134Medicare ID - Type Unspecified