Provider Demographics
NPI:1598838179
Name:REHDER, DOUGLAS EARL (AUD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:EARL
Last Name:REHDER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 LAREDO PL
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-1367
Mailing Address - Country:US
Mailing Address - Phone:406-656-7835
Mailing Address - Fax:
Practice Address - Street 1:1101 N 27TH ST
Practice Address - Street 2:SUITE E
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0101
Practice Address - Country:US
Practice Address - Phone:406-245-6893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSA73231H00000X, 231HA2400X, 231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000290218OtherBCBS
MT0535092Medicaid
MTM000002702Medicare PIN