Healthcare Provider Details

I. General information

NPI: 1770281370
Provider Name (Legal Business Name): VIGILANT ANESTHESIA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 TRIPLE TREE RD
BOZEMAN MT
59715-7821
US

IV. Provider business mailing address

330 TRIPLE TREE RD
BOZEMAN MT
59715-7821
US

V. Phone/Fax

Practice location:
  • Phone: 406-209-9699
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN PERRY JR.
Title or Position: MEMBER/ PARTNER
Credential: DNP, CRNA
Phone: 832-444-0150