Healthcare Provider Details

I. General information

NPI: 1891759197
Provider Name (Legal Business Name): IRENE S LOHKAMP MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N 29TH ST
BILLINGS MT
59101-0905
US

IV. Provider business mailing address

PO BOX 35100
BILLINGS MT
59107-5100
US

V. Phone/Fax

Practice location:
  • Phone: 406-238-2500
  • Fax:
Mailing address:
  • Phone: 406-238-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101041798
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number12538
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number12538
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: