Healthcare Provider Details

I. General information

NPI: 1255330791
Provider Name (Legal Business Name): ANESTHESIA PARTNERS OF MONTANA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 12TH AVE N SUITE 205W
BILLINGS MT
59101-7506
US

IV. Provider business mailing address

DEPARTMENT 0906
DENVER CO
80256-0001
US

V. Phone/Fax

Practice location:
  • Phone: 406-254-0707
  • Fax: 406-254-0709
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number7251
License Number StateMT

VIII. Authorized Official

Name: TAMI MCKELL
Title or Position: CREDENTIALING
Credential:
Phone: 406-254-0707