MEDICARE: FAMILY PRACTICE ASSOCIATES PC

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
1	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	C01394	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0404320001	OTHER	MT	DMERC

General Provider Information

NPI Number	:	1548488265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY PRACTICE ASSOCIATES PC

Provider Business Mailing Address
First Line	:	935 HIGHLAND BLVD
Second Line	:	SUITE 2210
City	:	BOZEMAN
State	:	MT
Zip	:	59715-6904
Country	:	US
Telephone Number	:	406-587-3133
Fax Number	:	406-596-9671

Provider Business Practice Location Address
First Line	:	935 HIGHLAND BLVD
Second Line	:	SUITE 2210
City	:	BOZEMAN
State	:	MT
Zip	:	59715-6904
Country	:	US
Telephone Number	:	406-587-3133
Fax Number	:	406-596-9671

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS HILDNER
Credential	:	M.D.
Telephone Number	:	406-587-3133

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	07/15/2010

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Directions to “FAMILY PRACTICE ASSOCIATES PC ” Practice Location

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