Healthcare Provider Details

I. General information

NPI: 1124007893
Provider Name (Legal Business Name): BRIAN F LUEPKE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 WAGON TRAIL RD # 1248
COLUMBUS MT
59019-7318
US

IV. Provider business mailing address

PO BOX 1248
COLUMBUS MT
59019-1248
US

V. Phone/Fax

Practice location:
  • Phone: 406-780-0818
  • Fax:
Mailing address:
  • Phone: 406-780-0818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMED-PHYS-LIC-25575
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: