Provider Demographics
NPI:1316371933
Name:ST. VINCENT HEALTHCARE
Entity Type:Organization
Organization Name:ST. VINCENT HEALTHCARE
Other - Org Name:ST. VINCENT PHYSICIAN NETWORK BIG SKY OB/GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVPN EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KINNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-237-4009
Mailing Address - Street 1:2900 12TH AVE N
Mailing Address - Street 2:SUITE 245W
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7506
Mailing Address - Country:US
Mailing Address - Phone:406-238-6010
Mailing Address - Fax:406-238-6022
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:SUITE 245W
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:406-238-6010
Practice Address - Fax:406-238-6022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-30
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT13258OtherLICENSE