Provider Demographics
NPI:1649318007
Name:BILLINGS FAMILY EYECARE, PC
Entity type:Organization
Organization Name:BILLINGS FAMILY EYECARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:406-245-2299
Mailing Address - Street 1:1540 LAKE ELMO DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-1797
Mailing Address - Country:US
Mailing Address - Phone:406-245-2299
Mailing Address - Fax:406-245-8302
Practice Address - Street 1:1540 LAKE ELMO DR
Practice Address - Street 2:SUITE 1
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-1797
Practice Address - Country:US
Practice Address - Phone:406-245-2299
Practice Address - Fax:406-245-8302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT419152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT26350OtherBLUE CROSS BLUE SHIELD
MTMT0419OtherEYEMED
MT000083330OtherMEDICARE GROUP
MT0482851Medicaid
MTP00040225OtherRAILROAD MEDICARE
MT0482851Medicaid
MT4892790001Medicare NSC