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General NPI Number Information
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NPI Number | 1245114743
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Entity Type | Organization
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Legal Business Name | MONTANA KIDNEY PLLC
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 310 N 1ST ST
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City | HAMILTON
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State | MT
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Zip | 59840-2528
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Country | US
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Telephone | 406-213-8939
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Fax | 406-224-6127
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Provider Business Mailing Address
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Address Line | PO BOX 18032
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City | MISSOULA
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State | MT
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Zip | 59808-8032
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN LAWSON
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Credential |
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Telephone | 406-213-8939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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