Provider Demographics
NPI:1346203460
Name:BABCOCK, CHEYENNE N (MD)
Entity Type:Individual
Prefix:DR
First Name:CHEYENNE
Middle Name:N
Last Name:BABCOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1155
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59103-1155
Mailing Address - Country:US
Mailing Address - Phone:406-248-3290
Mailing Address - Fax:406-248-3346
Practice Address - Street 1:2800 10TH AVE N
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0703
Practice Address - Country:US
Practice Address - Phone:406-248-3290
Practice Address - Fax:406-248-3346
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT61014207L00000X
WA38932207L00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC224778Medicaid
WAG8878379Medicare PIN
H21652Medicare UPIN
RH428969Medicare ID - Type Unspecified