# BIG SKY VASCULAR A SERIES OF TETON GROUP ENTERPRISES A DELAWARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Big Sky Vascular
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649669953
- **Authorized official:** MR. MICHAEL P HODEL (SECRETARY)
- **Authorized official phone:** (208) 542-5000

## Contact information

- **Practice address:** 3307 GRAND AVE STE 201, BILLINGS, MT 59102-6551
- **Practice address phone:** (406) 969-5194
- **Practice address fax:** (406) 969-5195
- **Mailing address:** PO BOX 1642, IDAHO FALLS, ID 83403-1642
- **Mailing address phone:** (208) 552-8761
- **Mailing address fax:** (208) 523-2025

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | MT | Yes |

## Other

- **Enumeration date:** 01/10/2015
- **Last updated:** 04/22/2015