Healthcare Provider Details

I. General information

NPI: 1568546919
Provider Name (Legal Business Name): BIG SKY RADIOLOGY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W PENNSYLVANIA ST
ANACONDA MT
59711-1931
US

IV. Provider business mailing address

PO BOX 5179
HELENA MT
59604-5179
US

V. Phone/Fax

Practice location:
  • Phone: 406-563-8661
  • Fax:
Mailing address:
  • Phone: 406-495-7263
  • Fax: 406-443-4526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: TOM ENGLAND
Title or Position: OWNER BILLING COMPANY
Credential:
Phone: 406-495-7220