Healthcare Provider Details

I. General information

NPI: 1891741807
Provider Name (Legal Business Name): FRENCHTOWN FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16862 BECKWITH ST
FRENCHTOWN MT
59834-9649
US

IV. Provider business mailing address

PO BOX 7666
MISSOULA MT
59807-7666
US

V. Phone/Fax

Practice location:
  • Phone: 406-626-5769
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN/A
License Number StateMT

VIII. Authorized Official

Name: JOYCE E STEVENS
Title or Position: DIRECTOR OF ANCILLARY/SATELLITE SVS
Credential:
Phone: 406-721-5600