Healthcare Provider Details

I. General information

NPI: 1114028735
Provider Name (Legal Business Name): PHILIP ALAN HESS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 TOWN CENTER AVE
BIG SKY MT
59716
US

IV. Provider business mailing address

110 N OAK ST
TOWNSEND MT
59644-2306
US

V. Phone/Fax

Practice location:
  • Phone: 406-995-6995
  • Fax:
Mailing address:
  • Phone: 406-266-3186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6474
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number40946
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: