Healthcare Provider Details

I. General information

NPI: 1891776787
Provider Name (Legal Business Name): ALAN STEVEN QUINT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 2ND ST E SUITE 206
KALISPELL MT
59901-6107
US

IV. Provider business mailing address

17 2ND ST E SUITE 206
KALISPELL MT
59901-6107
US

V. Phone/Fax

Practice location:
  • Phone: 406-755-3148
  • Fax: 406-755-3499
Mailing address:
  • Phone: 406-755-3148
  • Fax: 406-755-3499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number3771
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: