Provider Demographics
NPI:1487333217
Name:BILLINGS FAMILY EYECARE SHILOH PLLC
Entity type:Organization
Organization Name:BILLINGS FAMILY EYECARE SHILOH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DESPAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:406-245-2299
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:406-245-8302
Practice Address - Street 1:1686 SHILOH RD STE 3
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-1761
Practice Address - Country:US
Practice Address - Phone:406-245-2436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BILLINGS FAMILY OPTICAL PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-18
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty