Healthcare Provider Details

I. General information

NPI: 1417015801
Provider Name (Legal Business Name): KEITH D FOSTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2755 COLONIAL DR
HELENA MT
59601-4926
US

IV. Provider business mailing address

PO BOX 5539
HELENA MT
59604-5539
US

V. Phone/Fax

Practice location:
  • Phone: 406-444-7500
  • Fax: 406-444-7588
Mailing address:
  • Phone: 406-444-7500
  • Fax: 406-444-7588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number10028
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number10028
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number10028
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: