Healthcare Provider Details

I. General information

NPI: 1215482351
Provider Name (Legal Business Name): MEDICAL ASSOCIATES OF MONTANA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 02/18/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 MOUNTAIN SPRINGS RD
HELENA MT
59602-8433
US

IV. Provider business mailing address

601 MOUNTAIN SPRINGS RD
HELENA MT
59602-8433
US

V. Phone/Fax

Practice location:
  • Phone: 908-625-7887
  • Fax:
Mailing address:
  • Phone: 908-625-7887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC DAVID THOMAS
Title or Position: MANAGING DIRECTOR
Credential: MD
Phone: 908-625-7887