Provider Demographics
NPI:1083793244
Name:BIG SKY ONCOLOGY
Entity Type:Organization
Organization Name:BIG SKY ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREISDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:W
Authorized Official - Last Name:HARRER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-731-8100
Mailing Address - Street 1:1117 29TH ST S
Mailing Address - Street 2:SUITE 500
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5306
Mailing Address - Country:US
Mailing Address - Phone:406-731-8100
Mailing Address - Fax:406-731-8135
Practice Address - Street 1:1117 29TH ST S
Practice Address - Street 2:SUITE 500
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5306
Practice Address - Country:US
Practice Address - Phone:406-731-8100
Practice Address - Fax:406-731-8135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5278207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT=========OtherTIN