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NPI Code Detail

MEDICARE: MRS. LEEANNA IRVINE MUZQUIZ MD

MEDICARE: MRS. LEEANNA IRVINE MUZQUIZ MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMED-PHYS-LIC-10427MT

General Provider Information

NPI Number : 1447390166
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LEEANNA IRVINE MUZQUIZ MD
Provider Business Mailing Address
First Line : PO BOX 880
Second Line :
City : SAINT IGNATIUS
State : MT
Zip : 59865-0880
Country : US
Telephone Number : 406-745-3525
Fax Number : 406-226-2647
Provider Business Practice Location Address
First Line : 5 4TH AVE E
Second Line :
City : POLSON
State : MT
Zip : 59860-2117
Country : US
Telephone Number : 406-745-3525
Fax Number : 406-226-2647
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 04/08/2025

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