Healthcare Provider Details

I. General information

NPI: 1215527403
Provider Name (Legal Business Name): KALISPELL REGIONAL MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 SURGICAL SERVICES WAY
KALISPELL MT
59901-4844
US

IV. Provider business mailing address

1333 SURGICAL SERVICES WAY
KALISPELL MT
59901-4844
US

V. Phone/Fax

Practice location:
  • Phone: 406-751-5392
  • Fax: 406-751-5406
Mailing address:
  • Phone: 406-751-5392
  • Fax: 406-751-5406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: CLINTON SEGER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 406-752-1724