Provider Demographics
NPI:1275563678
Name:OFSTAD, ARNT JAMES (OD)
Entity Type:Individual
Prefix:
First Name:ARNT
Middle Name:JAMES
Last Name:OFSTAD
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 1:417 MAIN ST SW
Mailing Address - Street 2:
Mailing Address - City:RONAN
Mailing Address - State:MT
Mailing Address - Zip Code:59864-2738
Mailing Address - Country:US
Mailing Address - Phone:406-676-8921
Mailing Address - Fax:406-676-3938
Practice Address - Street 1:417 MAIN ST SW
Practice Address - Street 2:
Practice Address - City:RONAN
Practice Address - State:MT
Practice Address - Zip Code:59864-2738
Practice Address - Country:US
Practice Address - Phone:406-676-8921
Practice Address - Fax:406-676-3938
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT381OPT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000026180OtherBLUE CROSS BLUE SHIELD
MT410002038OtherRAILROAD MEDICARE
MT011000634OtherDMERC
MT0632920001OtherDMERC
MT810403250000OtherINDIAN HEALTH SERVICE
MT000002618OtherMEDICARE PIN
MT0489268Medicaid
MT0489268Medicaid
MT011000680Medicare PIN