Healthcare Provider Details

I. General information

NPI: 1083637672
Provider Name (Legal Business Name): JAMES E LINDERMAN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 12/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 WILSON ST STE 1
MILES CITY MT
59301-5094
US

IV. Provider business mailing address

2600 WILSON ST STE 1
MILES CITY MT
59301-5094
US

V. Phone/Fax

Practice location:
  • Phone: 406-233-2520
  • Fax: 406-233-4062
Mailing address:
  • Phone: 406-233-2520
  • Fax: 406-233-4062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number102
License Number StateMT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1841474087
Identifier TypeOTHER
Identifier StateMT
Identifier IssuerDMERC NORIDAN MEDICARE
# 2
Identifier1083637672
Identifier TypeMEDICAID
Identifier StateMT
Identifier Issuer
# 3
Identifier1841474087
Identifier TypeOTHER
Identifier StateMT
Identifier IssuerMEDICARE/GROUP NPI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: