Provider Demographics
NPI:1245427731
Name:HEART OF MONTANA SURGICAL SERVICES PC
Entity Type:Organization
Organization Name:HEART OF MONTANA SURGICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:SKIPPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-538-6262
Mailing Address - Street 1:310 WENDELL AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-2267
Mailing Address - Country:US
Mailing Address - Phone:406-538-6262
Mailing Address - Fax:406-538-6298
Practice Address - Street 1:310 WENDELL AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-2267
Practice Address - Country:US
Practice Address - Phone:406-538-6262
Practice Address - Fax:406-538-6298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10879208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1932143880OtherINDIVIDUAL NPI
F96398Medicare UPIN