Provider Demographics
NPI:1639157670
Name:ESSIG, ROBERT G (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:ESSIG
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 1:120 N 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3304
Mailing Address - Country:US
Mailing Address - Phone:406-587-0123
Mailing Address - Fax:
Practice Address - Street 1:120 N 7TH AVE
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3304
Practice Address - Country:US
Practice Address - Phone:406-587-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT376OPT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT26440OtherBLUE CROSS BLUE SHIELD
MT0483225Medicaid
MT26440OtherBLUE CROSS BLUE SHIELD