Healthcare Provider Details
I. General information
NPI: 1023450798
Provider Name (Legal Business Name): MEGAN A VIGIL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/23/2013
Last Update Date: 08/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
126 6TH AVE SW
RONAN MT
59864-2600
US
IV. Provider business mailing address
107 6TH AVE SW
RONAN MT
59864-2634
US
V. Phone/Fax
- Phone: 406-676-3600
- Fax: 406-676-3738
- Phone: 406-676-4441
- Fax: 406-676-0835
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 49316 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: