=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255371092
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LOUIS X KATTINE MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2006
-----------------------------------------------------
Last Update Date | 11/10/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2819 GREAT NORTHERN LOOP STE 200
-----------------------------------------------------
City | MISSOULA
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59808-1750
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-542-7525
-----------------------------------------------------
Fax | 406-829-0661
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 7817
-----------------------------------------------------
City | MISSOULA
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59807-7817
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-542-7525
-----------------------------------------------------
Fax | 406-829-0661
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 7329
-----------------------------------------------------
License Number State | MT
-----------------------------------------------------