Healthcare Provider Details

I. General information

NPI: 1548488265
Provider Name (Legal Business Name): FAMILY PRACTICE ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 HIGHLAND BLVD SUITE 2210
BOZEMAN MT
59715-6904
US

IV. Provider business mailing address

935 HIGHLAND BLVD SUITE 2210
BOZEMAN MT
59715-6904
US

V. Phone/Fax

Practice location:
  • Phone: 406-587-3133
  • Fax: 406-596-9671
Mailing address:
  • Phone: 406-587-3133
  • Fax: 406-596-9671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS HILDNER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 406-587-3133