Provider Demographics
NPI:1659316255
Name:MCMURRAY, KYLE D (OD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:D
Last Name:MCMURRAY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:91 W MADISON AVE
Mailing Address - Street 2:STE B
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-3915
Mailing Address - Country:US
Mailing Address - Phone:406-388-1988
Mailing Address - Fax:406-388-2488
Practice Address - Street 1:91 W MADISON AVE
Practice Address - Street 2:STE B
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-3915
Practice Address - Country:US
Practice Address - Phone:406-388-1988
Practice Address - Fax:406-388-2488
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT492152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2823OtherBLUE CROSS
T89271Medicare UPIN
2823OtherBLUE CROSS