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General NPI Number Information
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NPI Number | 1003157868
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Entity Type | Organization
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Legal Business Name | BIG SKY HEART PLLC
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 2900 12TH AVE N STE 301E
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City | BILLINGS
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State | MT
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Zip | 59101-7504
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Country | US
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Telephone | 406-237-5888
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Fax | 406-237-5889
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Provider Business Mailing Address
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Address Line | 2900 12TH AVE N STE 301E
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City | BILLINGS
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State | MT
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Zip | 59101-7504
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Country | US
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Telephone | 406-237-5888
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Fax | 406-237-5889
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Authorized Official
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Title or Position | OWNER
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Name | DR. KIPP BRADLEY WEBB
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Credential | MD
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Telephone | 406-237-5888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 6084
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License Number State | MT
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