Organization
DR. GREGORY CAVANAUGH OD PC
Active
Other names
Family Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY CAVANAUGH OD (OWNER)
(406) 482-2609
Entity
Organization
Contact information
Practice address
112 2ND ST SE, SIDNEY, MT 59270-4104
(406) 482-2609
(406) 482-2697
Mailing address
PO BOX 1008, SIDNEY, MT 59270-1008
(406) 482-2609
(406) 482-2697
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
415OPT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000026210
BCBS
MT
05
—
0487019
—
MT
01
—
4064822609
VSP
MT
01
—
410007688
RAILROAD MEDICARE
MT
01
—
893290
ND VISION
MT
Enumeration date
04/05/2010
Last updated
08/09/2012
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