Provider Demographics
NPI:1134103310
Name:MCMASTER, RICHARD BRUCE (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BRUCE
Last Name:MCMASTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-2403
Mailing Address - Country:US
Mailing Address - Phone:406-538-2020
Mailing Address - Fax:406-538-8988
Practice Address - Street 1:821 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-2403
Practice Address - Country:US
Practice Address - Phone:406-538-2020
Practice Address - Fax:406-538-8988
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT573OPT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0483756Medicaid
MT000002936Medicare PIN
MT0483756Medicaid
U40136Medicare UPIN