Healthcare Provider Details

I. General information

NPI: 1740446632
Provider Name (Legal Business Name): ST. JAMES HEALTHCARE ORTHOPEDIC BILLING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 S CRYSTAL ST STE 400
BUTTE MT
59701-1506
US

IV. Provider business mailing address

400 S CLARK ST
BUTTE MT
59701-2328
US

V. Phone/Fax

Practice location:
  • Phone: 406-496-3400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE FANTINI
Title or Position: PHYSICIAN CONTRACTING
Credential:
Phone: 406-723-2436