Provider Demographics
NPI:1407041882
Name:MORLEDGE FAMILY EYE FOUNDATION, PLLC
Entity Type:Organization
Organization Name:MORLEDGE FAMILY EYE FOUNDATION, PLLC
Other - Org Name:MORLEDGE FAMILY EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MORLEDGE-HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-294-1994
Mailing Address - Street 1:1747 POLY DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-1724
Mailing Address - Country:US
Mailing Address - Phone:406-294-1994
Mailing Address - Fax:406-294-1996
Practice Address - Street 1:1747 POLY DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-1724
Practice Address - Country:US
Practice Address - Phone:406-294-1994
Practice Address - Fax:406-294-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10586207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000094566OtherBLUE CROSS BLUE SHIELD OF MT
MTZZ207W00000XMedicaid
MT1407041882OtherWISCONSIN PHYSICIANS SERVICE
MT10586OtherSTATE LICENSE
MTP00445065OtherRAILROAD MEDICARE
MTP00445065OtherRAILROAD MEDICARE