Healthcare Provider Details

I. General information

NPI: 1629065891
Provider Name (Legal Business Name): JAMES B WHITWORTH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 02/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 N 29TH ST
BILLINGS MT
59101-0122
US

IV. Provider business mailing address

PO BOX 219
BILLINGS MT
59103-0219
US

V. Phone/Fax

Practice location:
  • Phone: 406-252-5658
  • Fax: 406-238-3617
Mailing address:
  • Phone: 406-252-5658
  • Fax: 406-238-3617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number6910
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: