Healthcare Provider Details
I. General information
NPI: 1043259484
Provider Name (Legal Business Name): BILLINGS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2006
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
710 NORTH 11TH STREET
COLUMBUS MT
59019-7215
US
IV. Provider business mailing address
PO BOX 35100
BILLINGS MT
59107-5100
US
V. Phone/Fax
- Phone: 406-322-4542
- Fax:
- Phone: 406-238-2500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHLEEN
ROSSIE
QUINONES
Title or Position: CFO
Credential:
Phone: 406-435-6445