Provider Demographics
NPI:1508816190
Name:YELLOWSTONE UROLOGY, PLLC
Entity Type:Organization
Organization Name:YELLOWSTONE UROLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:OKSENDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-237-5411
Mailing Address - Street 1:2900 12TH AVE N
Mailing Address - Street 2:503E
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7506
Mailing Address - Country:US
Mailing Address - Phone:406-237-5400
Mailing Address - Fax:406-237-5420
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:503E
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:406-237-5400
Practice Address - Fax:406-237-5420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty