Provider Demographics
NPI:1447432182
Name:BIG SKY ORTHOPEDICS INC
Entity Type:Organization
Organization Name:BIG SKY ORTHOPEDICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRYANT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GULDE
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:406-655-1933
Mailing Address - Street 1:1020 S 24TH ST W
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6406
Mailing Address - Country:US
Mailing Address - Phone:406-655-1933
Mailing Address - Fax:
Practice Address - Street 1:1020 S 24TH ST W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6406
Practice Address - Country:US
Practice Address - Phone:406-655-1933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT310720OtherBCBS
MT5601874Medicaid
MT5601874Medicaid