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General NPI Number Information
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NPI Number | 1497820559
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Entity Type | Organization
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Legal Business Name | RADIOLOGY MONTANA, PC
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 09/06/2019
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Provider Practice Location Address
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Address Line | 1101 26TH ST S
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City | GREAT FALLS
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State | MT
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Zip | 59405-5161
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Country | US
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Telephone | 406-452-5057
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Fax | 903-663-7394
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Provider Business Mailing Address
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Address Line | PO BOX 9039
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City | LONGVIEW
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State | TX
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Zip | 75608-9039
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Country | US
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Telephone | 406-452-5057
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Fax | 903-663-7394
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Authorized Official
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Title or Position | PRESIDENT
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Name | TYLER L. WILL
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Credential | MD
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Telephone | 406-452-5057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology 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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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