Provider Demographics
NPI:1750580361
Name:CREGER, DOUGLAS D (OD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:D
Last Name:CREGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT544152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT031094477OtherWORKERS COMPENSATION
MT410048154OtherRAILROAD MEDICARE
MT000027780OtherBLUE CROSS BLUE SHIELD
MT0482482Medicaid
MT011001831Medicare PIN
MT000027780OtherBLUE CROSS BLUE SHIELD
MT410048154OtherRAILROAD MEDICARE