Healthcare Provider Details

I. General information

NPI: 1801882139
Provider Name (Legal Business Name): JAMES L WHITTLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 08/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 26TH ST S 5TH FLOOR
GREAT FALLS MT
59405-5161
US

IV. Provider business mailing address

1101 26TH ST S 5TH FLOOR
GREAT FALLS MT
59405-5161
US

V. Phone/Fax

Practice location:
  • Phone: 406-731-8888
  • Fax: 406-731-8876
Mailing address:
  • Phone: 406-731-8888
  • Fax: 406-731-8876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number10864
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: