Healthcare Provider Details

I. General information

NPI: 1932324860
Provider Name (Legal Business Name): MARTIN K GELBKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 ELLIS ST SUITE 201
BOZEMAN MT
59715-8812
US

IV. Provider business mailing address

1450 ELLIS ST SUITE 201
BOZEMAN MT
59715-8812
US

V. Phone/Fax

Practice location:
  • Phone: 406-587-0122
  • Fax: 406-587-5548
Mailing address:
  • Phone: 406-587-0122
  • Fax: 406-587-5548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number12641
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: