Provider Demographics
NPI:1710119664
Name:CENTERS FOR ADVANCED VEIN CARE OF MONTANA PLLC
Entity Type:Organization
Organization Name:CENTERS FOR ADVANCED VEIN CARE OF MONTANA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:ORCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-727-8346
Mailing Address - Street 1:PO BOX 30212
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-0212
Mailing Address - Country:US
Mailing Address - Phone:406-727-8346
Mailing Address - Fax:
Practice Address - Street 1:1417 9TH ST S STE 201
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4509
Practice Address - Country:US
Practice Address - Phone:406-727-8346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty