Provider Demographics
NPI:1245292366
Name:EYE PHYSICIANS OPTICAL
Entity type:Organization
Organization Name:EYE PHYSICIANS OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:406-252-5681
Mailing Address - Street 1:1221 N 26TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0232
Mailing Address - Country:US
Mailing Address - Phone:406-252-5681
Mailing Address - Fax:406-252-5025
Practice Address - Street 1:1221 N 26TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0232
Practice Address - Country:US
Practice Address - Phone:406-252-5681
Practice Address - Fax:406-252-5025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000002643OtherPTAN
MT0558285Medicaid
WY117412600Medicaid
MT0669590001Medicare NSC