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General NPI Number Information
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NPI Number | 1184969842
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Entity Type | Organization
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Legal Business Name | HIGH COUNTRY LUNG & SLEEP DISORDERS CLINIC, PC
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 06/10/2013
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Provider Practice Location Address
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Address Line | 505 W PARK ST SUITE A
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City | BUTTE
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State | MT
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Zip | 59701-9106
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Country | US
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Telephone | 406-782-8988
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Fax | 406-782-3566
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Provider Business Mailing Address
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Address Line | 505 W PARK ST SUITE A
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City | BUTTE
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State | MT
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Zip | 59701-9106
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Country | US
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Telephone | 406-782-8988
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Fax | 406-782-3566
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEITH JANES POPOVICH
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Credential | MD
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Telephone | 406-782-8988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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