Healthcare Provider Details

I. General information

NPI: 1861031122
Provider Name (Legal Business Name): SCL HEALTH MEDICAL GROUP-BUTTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 S MAIN ST
BOULDER MT
59632-7640
US

IV. Provider business mailing address

200 S CLARK ST
BUTTE MT
59701-1500
US

V. Phone/Fax

Practice location:
  • Phone: 406-225-4201
  • Fax: 406-225-9161
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JON MCDANIEL
Title or Position: VP FINANCE MEDICAL GROUP
Credential:
Phone: 303-272-0231