Provider Demographics
NPI:1730344698
Name:DESPAIN, DEVIN BURTON (OD)
Entity type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:BURTON
Last Name:DESPAIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 LAKE ELMO DR STE 1
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-1798
Mailing Address - Country:US
Mailing Address - Phone:406-245-2299
Mailing Address - Fax:
Practice Address - Street 1:1540 LAKE ELMO DR STE 1
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-1798
Practice Address - Country:US
Practice Address - Phone:406-245-2299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT800152WP0200X, 152W00000X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy