Provider Demographics
NPI:1588799860
Name:YPMA, TROY R (OD)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:R
Last Name:YPMA
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 1:211 - 5TH STREET WEST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912
Mailing Address - Country:US
Mailing Address - Phone:406-892-4140
Mailing Address - Fax:406-892-4146
Practice Address - Street 1:211 5TH ST W
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-3607
Practice Address - Country:US
Practice Address - Phone:406-892-4140
Practice Address - Fax:406-892-4146
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT768152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0483616Medicaid
MT28261OtherBLUE CROSS BLUE SHIELD
MT000025155Medicare PIN
MT28261OtherBLUE CROSS BLUE SHIELD
MT0483616Medicaid