Individual
JEFFERSON BERRYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 W KENT AVE, MISSOULA, MT 59801-6772
(406) 541-3937
(406) 541-3811
Mailing address
700 W KENT AVE, MISSOULA, MT 59801-6772
(952) 888-5800
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
98709
MT
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
98709
MT
Other
Enumeration date
03/23/2016
Last updated
08/12/2024
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