Provider Demographics
NPI:1710089222
Name:BIG SKY NEUROSCIENCE AND SPINE INSTITUTE, PLLC
Entity Type:Organization
Organization Name:BIG SKY NEUROSCIENCE AND SPINE INSTITUTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:M
Authorized Official - Last Name:SORINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-782-6391
Mailing Address - Street 1:700 W GOLD ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2320
Mailing Address - Country:US
Mailing Address - Phone:406-782-6391
Mailing Address - Fax:406-782-6585
Practice Address - Street 1:700 W GOLD ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2320
Practice Address - Country:US
Practice Address - Phone:406-782-6391
Practice Address - Fax:406-782-6585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-04
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4505370001Medicare NSC
MT000083440Medicare ID - Type Unspecified