Healthcare Provider Details

I. General information

NPI: 1700637907
Provider Name (Legal Business Name): GRANITE PEAK ANESTHESIOLOGY CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 10TH AVE N
BILLINGS MT
59101-0703
US

IV. Provider business mailing address

PO BOX 819
BELLEVUE NE
68005-0819
US

V. Phone/Fax

Practice location:
  • Phone: 406-657-4000
  • Fax:
Mailing address:
  • Phone: 425-407-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: LUKE VAN ALSTINE
Title or Position: PRESIDENT
Credential: MD
Phone: 406-531-3881