Provider Demographics
NPI:1942283494
Name:CREGER FAMILY EYE CARE, PC
Entity Type:Organization
Organization Name:CREGER FAMILY EYE CARE, PC
Other - Org Name:DOUGLAS D CREGER OD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:CREGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:406-683-2611
Mailing Address - Street 1:PO BOX 27
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-0027
Mailing Address - Country:US
Mailing Address - Phone:406-683-2611
Mailing Address - Fax:406-683-2676
Practice Address - Street 1:233 E GLENDALE ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-2707
Practice Address - Country:US
Practice Address - Phone:406-683-2611
Practice Address - Fax:406-683-2676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-29
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT544152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000027780OtherBLUE CROSS BLUE SHIELD
MT0482482Medicaid
MT410048154OtherRAILROAD MEDICARE
MT000027780OtherBLUE CROSS BLUE SHIELD
MT410048154OtherRAILROAD MEDICARE
MT0295250001Medicare NSC