Provider Demographics
NPI:1679682413
Name:SIBBITT, RANDY R (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:R
Last Name:SIBBITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4949
Mailing Address - Country:US
Mailing Address - Phone:406-442-7227
Mailing Address - Fax:406-442-1450
Practice Address - Street 1:25 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4949
Practice Address - Country:US
Practice Address - Phone:406-442-7227
Practice Address - Fax:406-442-1450
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT16796824132085R0202X
MT76302085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT97085OtherBLUE CROSS BLUE SHIELD
MT0074817Medicaid
MT000083966Medicare ID - Type Unspecified
MT0074817Medicaid