Healthcare Provider Details

I. General information

NPI: 1245255348
Provider Name (Legal Business Name): JAMES R FEIST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 HIGHLAND BLVD SUITE 4400
BOZEMAN MT
59715-6904
US

IV. Provider business mailing address

935 HIGHLAND BLVD SUITE 4400
BOZEMAN MT
59715-6904
US

V. Phone/Fax

Practice location:
  • Phone: 406-587-5123
  • Fax: 406-556-6758
Mailing address:
  • Phone: 406-587-5123
  • Fax: 406-556-6758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4071
License Number StateMT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier48425
Identifier TypeMEDICAID
Identifier StateMT
Identifier Issuer
# 2
Identifier11190
Identifier TypeOTHER
Identifier StateMT
Identifier IssuerBCBS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: