Provider Demographics
NPI:1770681991
Name:BIG SKY COSMETIC SURGERY, PC
Entity Type:Organization
Organization Name:BIG SKY COSMETIC SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:HETHERINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-522-3770
Mailing Address - Street 1:925 HIGHLAND BLVD
Mailing Address - Street 2:SUITE 1190
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6900
Mailing Address - Country:US
Mailing Address - Phone:406-522-3770
Mailing Address - Fax:406-586-5412
Practice Address - Street 1:925 HIGHLAND BLVD
Practice Address - Street 2:SUITE 1190
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6900
Practice Address - Country:US
Practice Address - Phone:406-522-3770
Practice Address - Fax:406-586-5412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6361207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty