Healthcare Provider Details

I. General information

NPI: 1194662064
Provider Name (Legal Business Name): VANCE THOMPSON VISION SURGERY CENTER BOZEMAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 WILLOW PEAK DR
BOZEMAN MT
59718-9811
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 402-219-0700
  • Fax: 605-371-7199
Mailing address:
  • Phone: 605-799-2230
  • 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: MARK ALLEN SCHARNBERG
Title or Position: CFO
Credential:
Phone: 605-359-9155