Organization · NPI-2
Bozeman Health Deaconess Hospital
Family Medicine · Bozeman, MT
NPI number1427612845
StatusActive
Last updated in NPPESNov 19, 2024
Details
- NPI
- 1427612845
- Entity type
- Organization (NPI-2)
- Legal business name
- Bozeman Health Deaconess Hospital
- Organization subpart
- No
- Enumeration date
- May 1, 2019
- Certification date
- Nov 19, 2024
- Last updated
- Nov 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 363A00000X | Physician Assistant | – | – | |
| 363L00000X | Nurse Practitioner | – | – |
Other names
- Bozeman Health Family Medicine Clinic Medicaid Passport Npi (Other Name)
Practice location
935 Highland Blvd Ste 2200Bozeman, MT 59715-6915
Phone 406-414-5700
Mailing address
915 Highland Blvd Ste 2170Bozeman, MT 59715-6902
Phone 406-414-5552
Authorized official
Brad K Ludford
Cfo
4064141036
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