Healthcare Provider Details

I. General information

NPI: 1013489095
Provider Name (Legal Business Name): SCOTT W FALLEY MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2019
Last Update Date: 04/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N MONTANA AVE
HELENA MT
59601-3515
US

IV. Provider business mailing address

1200 N MONTANA AVE
HELENA MT
59601-3515
US

V. Phone/Fax

Practice location:
  • Phone: 406-431-7332
  • Fax: 406-996-1511
Mailing address:
  • Phone: 406-431-7332
  • Fax: 406-996-1511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT WAYNE FALLEY
Title or Position: OWNER
Credential: MD
Phone: 406-431-7332