Healthcare Provider Details

I. General information

NPI: 1679658074
Provider Name (Legal Business Name): LOGAN HEALTH - WHITEFISH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HOSPITAL WAY
WHITEFISH MT
59937
US

IV. Provider business mailing address

1600 HOSPITAL WAY
WHITEFISH MT
59937-7849
US

V. Phone/Fax

Practice location:
  • Phone: 406-863-3500
  • Fax: 406-862-7805
Mailing address:
  • Phone: 406-863-3500
  • Fax: 406-863-3516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number10361
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number11442
License Number StateMT

VIII. Authorized Official

Name: KEVIN ABEL
Title or Position: PRESIDENT
Credential:
Phone: 406-752-1724