Healthcare Provider Details

I. General information

NPI: 1033164447
Provider Name (Legal Business Name): BILLINGS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 WICKS LN
BILLINGS MT
59105-4427
US

IV. Provider business mailing address

PO BOX 37000
BILLINGS MT
59107-7000
US

V. Phone/Fax

Practice location:
  • Phone: 406-238-2575
  • Fax:
Mailing address:
  • Phone: 406-238-2575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN QUINONES
Title or Position: CFO
Credential:
Phone: 406-238-2500