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General NPI Number Information
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NPI Number | 1447535869
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Entity Type | Organization
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Legal Business Name | WILLIAM R. MEALER, M.D., INC.
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 300 N WILLSON AVE SUITE 300-C
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City | BOZEMAN
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State | MT
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Zip | 59715-3551
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Country | US
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Telephone | 406-585-2700
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Fax | 406-585-2751
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Provider Business Mailing Address
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Address Line | 300 N WILLSON AVE SUITE 300-C
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City | BOZEMAN
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State | MT
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Zip | 59715-3551
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Country | US
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Telephone | 406-585-2700
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Fax | 406-585-2751
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Authorized Official
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Title or Position | SOLE SHAREHOLDER
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Name | DR. WILLIAM RANDALL MEALER
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Credential | MD
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Telephone | 406-585-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 9651
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License Number State | MT
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