Bozeman Health Deaconess Hospital
Family Medicine in Bozeman, MT. Organization (NPI-2).
NPI number1316531320
StatusActive
Last updated in NPPESNov 19, 2024
Details
- NPI
- 1316531320
- Entity type
- Organization (NPI-2)
- Legal business name
- Bozeman Health Deaconess Hospital
- Organization subpart
- No
- Enumeration date
- Feb 22, 2021
- Certification date
- Nov 19, 2024
- Last updated
- Nov 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207R00000X | Internal Medicine | – | – | |
| 208000000X | Pediatrics | – | – | |
| 363A00000X | Physician Assistant | – | – | |
| 363L00000X | Nurse Practitioner | – | – |
Other names
- Bozeman Health Cottonwood Primary Care Medicaid Passport Npi (Other Name)
Practice location
875 S Cottonwood Rd Ste 300Bozeman, MT 59718-4208
Phone 406-414-4100
Mailing address
915 Highland BlvdBozeman, MT 59715-6902
Phone 406-414-5552
Authorized official
Brad K Ludford
Cfo
4064141036
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