Healthcare Provider Details

I. General information

NPI: 1245325851
Provider Name (Legal Business Name): JAMES TENNENT GEREN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 26TH ST S
GREAT FALLS MT
59405-5161
US

IV. Provider business mailing address

1005 GEORGIANA STREET
PORT ANGELES WA
98362-3917
US

V. Phone/Fax

Practice location:
  • Phone: 406-731-8888
  • Fax: 406-731-8876
Mailing address:
  • Phone: 360-417-0110
  • Fax: 360-417-7114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD00034965
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number56868
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: