Healthcare Provider Details

I. General information

NPI: 1013119171
Provider Name (Legal Business Name): PLAINS SYNERGY HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S MERRILL AVE SUITE #24
GLENDIVE MT
59330-1635
US

IV. Provider business mailing address

100 1/2 S. MERRILL AVE. SUITE #24
GLENDIVE MT
59330
US

V. Phone/Fax

Practice location:
  • Phone: 406-377-1179
  • Fax:
Mailing address:
  • Phone: 406-377-1179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9958
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9958
License Number StateMT

VIII. Authorized Official

Name: JOAN DICKSON
Title or Position: OWNER
Credential: M.D.
Phone: 406-377-1179