Provider Demographics
NPI:1275668071
Name:BILLINGS FOOT AND ANKLE
Entity Type:Organization
Organization Name:BILLINGS FOOT AND ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:OURADNIK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:406-651-0767
Mailing Address - Street 1:71 25TH ST W
Mailing Address - Street 2:PO BOX 20919
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4684
Mailing Address - Country:US
Mailing Address - Phone:406-651-0767
Mailing Address - Fax:406-652-0174
Practice Address - Street 1:71 25TH ST W
Practice Address - Street 2:SUITE 12
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4684
Practice Address - Country:US
Practice Address - Phone:406-651-0767
Practice Address - Fax:406-652-0174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT162213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTDC5626OtherRAILROAD MEDICARE
MT000084322Medicare ID - Type Unspecified