Healthcare Provider Details

I. General information

NPI: 1447260799
Provider Name (Legal Business Name): JEFF S. PFLUG MA, L.A.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 11/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MONTANA STATE HOSPITAL
WARM SPRINGS MT
59756-2119
US

IV. Provider business mailing address

PO BOX 300
WARM SPRINGS MT
59756-0300
US

V. Phone/Fax

Practice location:
  • Phone: 406-693-7060
  • Fax:
Mailing address:
  • Phone: 406-693-7060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1012
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: