Healthcare Provider Details

I. General information

NPI: 1174654206
Provider Name (Legal Business Name): MARK F. OZOG M.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 9TH ST S STE 100
GREAT FALLS MT
59405-4509
US

IV. Provider business mailing address

1417 9TH ST S STE 100
GREAT FALLS MT
59405-4509
US

V. Phone/Fax

Practice location:
  • Phone: 406-453-1613
  • Fax: 406-453-3717
Mailing address:
  • Phone: 406-453-1613
  • Fax: 406-453-3717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number7816
License Number StateMT

VIII. Authorized Official

Name: MRS. AMANDA HUHTALA
Title or Position: MANAGER
Credential:
Phone: 406-453-1613