Healthcare Provider Details

I. General information

NPI: 1821281866
Provider Name (Legal Business Name): ELISABETH D EREKSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 10TH AVE S
GREAT FALLS MT
59405-3240
US

IV. Provider business mailing address

PO BOX 6010
GREAT FALLS MT
59406-6010
US

V. Phone/Fax

Practice location:
  • Phone: 406-731-8017
  • Fax: 406-731-8001
Mailing address:
  • Phone: 406-455-5000
  • Fax: 406-731-8318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number164699
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: