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General NPI Number Information
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NPI Number | 1053341222
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Entity Type | Organization
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Legal Business Name | NORTH CENTRAL PRIMARY CARE ASSOCIATES
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 400 13TH AVE S STE 206
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City | GREAT FALLS
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State | MT
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Zip | 59405-4300
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Country | US
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Telephone | 406-771-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 400 13TH AVE S STE 206
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City | GREAT FALLS
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State | MT
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Zip | 59405-4300
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Country | US
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Telephone | 406-771-7300
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | STACEY L PEDERSON
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Credential |
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Telephone | 406-771-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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