Healthcare Provider Details

I. General information

NPI: 1659669224
Provider Name (Legal Business Name): THE SLEEP MEDICINE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 COMMONS WAY SUITE D
KALISPELL MT
59901-1915
US

IV. Provider business mailing address

200 COMMONS WAY SUITE D
KALISPELL MT
59901-1915
US

V. Phone/Fax

Practice location:
  • Phone: 406-752-2015
  • Fax: 406-752-2519
Mailing address:
  • Phone: 406-752-2015
  • Fax: 406-752-2519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK J BURNS
Title or Position: OWNER
Credential: D.O.
Phone: 406-752-2015