Healthcare Provider Details

I. General information

NPI: 1184677981
Provider Name (Legal Business Name): LAWRENCE A ALVARADO III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: LARRY A ALVARADO III MD

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 HIGHLAND BLVD
BOZEMAN MT
59715-6900
US

IV. Provider business mailing address

3133 SUMMER VIEW LN
BOZEMAN MT
59715-8255
US

V. Phone/Fax

Practice location:
  • Phone: 406-599-9561
  • Fax:
Mailing address:
  • Phone: 509-910-0569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD00046400
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMED-PHYS-LIC-44405
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01097542A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD00046400
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: