Healthcare Provider Details

I. General information

NPI: 1275822405
Provider Name (Legal Business Name): BETHANY ANN WEILER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BETHANY WEILER-LISOWSKI

II. Dates (important events)

Enumeration Date: 03/28/2011
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 HERITAGE WAY STE 2100
KALISPELL MT
59901
US

IV. Provider business mailing address

350 HERITAGE WAY STE 2100
KALISPELL MT
59901-3167
US

V. Phone/Fax

Practice location:
  • Phone: 406-257-8992
  • Fax: 406-257-8996
Mailing address:
  • Phone: 406-257-8992
  • Fax: 406-257-8996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number77439
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number77439
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number49717
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: