Healthcare Provider Details
I. General information
NPI: 1518949270
Provider Name (Legal Business Name): BRADFORD P. WHITCOMB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/17/2005
Last Update Date: 01/13/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 N 29TH ST
BILLINGS MT
59101-0905
US
IV. Provider business mailing address
BILLINGS CLINIC CANCER CENTER 801 N. 29TH STREET
BILLINGS MT
59101
US
V. Phone/Fax
- Phone: 406-435-7340
- Fax: 406-435-7349
- Phone: 406-435-7340
- Fax: 406-435-7349
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 2002012320 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | 055981 |
| License Number State | CT |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | 128973 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: