Organization
EYE CLINIC OF GREAT FALLS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK J STIBEL OD (PRESIDENT)
(406) 452-9507
Entity
Organization
Contact information
Practice address
509 2ND AVE N, GREAT FALLS, MT 59401
(406) 452-9507
(406) 452-2015
Mailing address
PO BOX 3427, GREAT FALLS, MT 59403-3427
(406) 452-9507
(406) 452-2015
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
470
MT
152W00000X
Optometrist
568
MT
152W00000X
Optometrist
794
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0480480
—
MT
05
—
0483353
—
MT
01
—
25743
BC
MT
01
—
26540
BC
MT
01
—
28000
BC
MT
Enumeration date
03/24/2006
Last updated
05/02/2011
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