Individual
DR. JOSEPH KYLE PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
127 VILLAGE DR, SUITE 300, BELGRADE, MT 59714-9617
(406) 388-9661
(406) 388-9662
Mailing address
127 VILLAGE DR, STE 300, BELGRADE, MT 59714-9617
(406) 388-9661
(406) 388-9662
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
774
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000028301
BCBS MONTANA PROVIDER ID
MT
05
—
0483701
—
MT
01
—
203416109
FEDERAL TAX ID
MT
Enumeration date
12/14/2006
Last updated
07/25/2007
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