Healthcare Provider Details

I. General information

NPI: 1760528459
Provider Name (Legal Business Name): FLATHEAD HOSPITALIST PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 SUNNYVIEW LANE
KALISPELL MT
59901
US

IV. Provider business mailing address

PO BOX 3031
KALISPELL MT
59903
US

V. Phone/Fax

Practice location:
  • Phone: 406-752-5111
  • Fax:
Mailing address:
  • Phone: 406-755-2823
  • Fax: 406-257-4820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK T WELCH
Title or Position: OWNER
Credential: MD
Phone: 406-752-5111