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PROVIDENCE HEALTH & SERVICES MT NPI 1730325440


NPI Information

NPI: 1730325440
Provider Name: PROVIDENCE HEALTH & SERVICES MT

Doing Business As: PMG MT MONTANA INTERNAL MED

Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
2819 GREAT NORTHERN LOOP
SUITE 200
MISSOULA, MT
ZIP 59808
Phone: (406) 543-1197
Get Directions

PROVIDENCE HEALTH & SERVICES MT is an internal medicine in Missoula, MT. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PROVIDENCE HEALTH & SERVICES MT NPI is 1730325440. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Pmg Mt Montana Internal Med.

The provider's business location address is:

2819 GREAT NORTHERN LOOP
SUITE 200
MISSOULA, MT
ZIP 59808-750
Phone: (406) 543-1197
Fax: (406) 543-0515

The provider's authorized official is Kirk Bodlovic .
The authorized official title is Cfo and has the following contact phone number (406) 327-1918.

The enumeration date for this NPI number is 12/30/2008 and was last updated on 11/22/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine0411866MONTANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1M000009936MEDICARE PINMONTANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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