Provider Demographics
NPI:1063634145
Name:MONTANA VALLEY EYE CLINIC, PLLC
Entity Type:Organization
Organization Name:MONTANA VALLEY EYE CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:DON
Authorized Official - Last Name:NEUMEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-728-0044
Mailing Address - Street 1:2687 PALMER ST STE C2
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1710
Mailing Address - Country:US
Mailing Address - Phone:406-728-0044
Mailing Address - Fax:406-728-0494
Practice Address - Street 1:2687 PALMER ST STE C2
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1710
Practice Address - Country:US
Practice Address - Phone:406-728-0044
Practice Address - Fax:406-728-0494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6078207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000012614Medicaid
MT0000012648Medicaid
MT0000012920Medicaid
MT0000109694Medicaid
ID002239600Medicaid
MT01-14442-7OtherST FUND
MT180034859OtherRAILROAD MEDICARE
MT9622-0OtherBCBS
MT0550409Medicaid
MT01-14442-7OtherST FUND
MTC64270Medicare UPIN
MT0000109694Medicaid