Provider Demographics
NPI:1730278268
Name:FINK, JODY LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:JODY
Middle Name:LYNN
Last Name:FINK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 W MADISON AVE
Mailing Address - Street 2:STE B
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-3915
Mailing Address - Country:US
Mailing Address - Phone:307-431-5225
Mailing Address - Fax:
Practice Address - Street 1:91 W MADISON AVE
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-3915
Practice Address - Country:US
Practice Address - Phone:406-388-1988
Practice Address - Fax:406-388-2488
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY300T152W00000X
MT776152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY20618Medicare ID - Type Unspecified
WYV07758Medicare UPIN