Healthcare Provider Details

I. General information

NPI: 1336157916
Provider Name (Legal Business Name): CONLEY LYNCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 04/21/2021
Certification Date: 04/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 PARK AVE
SHELBY MT
59474-1663
US

IV. Provider business mailing address

670 PARK AVE
SHELBY MT
59474-1663
US

V. Phone/Fax

Practice location:
  • Phone: 406-434-3100
  • Fax: 406-434-3143
Mailing address:
  • Phone: 406-434-3100
  • Fax: 406-434-3143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number987209
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD21190
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: