Provider Demographics
NPI:1366468068
Name:GASKILL, ROBERT RAY (OD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:RAY
Last Name:GASKILL
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 1:2203 BROADWATER AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4713
Mailing Address - Country:US
Mailing Address - Phone:406-652-4455
Mailing Address - Fax:406-794-0536
Practice Address - Street 1:2203 BROADWATER AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4713
Practice Address - Country:US
Practice Address - Phone:406-652-4455
Practice Address - Fax:406-794-0536
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5970OPT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0482766Medicaid
MTP00002753OtherRAILROAD MEIDCARE
MTU51031Medicare UPIN