Healthcare Provider Details

I. General information

NPI: 1437794625
Provider Name (Legal Business Name): VANCE THOMPSON VISION SURGERY CENTER BILLINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 06/19/2023
Certification Date: 06/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1747 POLY DR
BILLINGS MT
59102-1728
US

IV. Provider business mailing address

3101 W 57TH ST
SIOUX FALLS SD
57108-3162
US

V. Phone/Fax

Practice location:
  • Phone: 406-294-1994
  • Fax: 605-371-7199
Mailing address:
  • Phone: 605-361-3937
  • Fax: 605-371-7199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN PALMER BERDAHL
Title or Position: OWNER
Credential: MD
Phone: 605-610-8881