Healthcare Provider Details

I. General information

NPI: 1417971557
Provider Name (Legal Business Name): SCOTT WAYNE FALLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 KNAPP ST
WOLF POINT MT
59201-1826
US

IV. Provider business mailing address

439 W LAWRENCE ST
HELENA MT
59601-6167
US

V. Phone/Fax

Practice location:
  • Phone: 406-431-7332
  • Fax: 406-996-1511
Mailing address:
  • Phone: 406-465-7610
  • Fax: 406-324-7066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number11287
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD16749
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: