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General NPI Number Information
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NPI Number | 1508808874
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Entity Type | Organization
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Legal Business Name | MISSOULA SURGICAL ASSOCIATES, PLLC
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 2819 GREAT NORTHERN LOOP STE 200
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City | MISSOULA
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State | MT
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Zip | 59808-1750
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Country | US
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Telephone | 406-542-7525
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Fax | 406-829-0661
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Provider Business Mailing Address
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Address Line | PO BOX 7817
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City | MISSOULA
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State | MT
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Zip | 59807-7817
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Country | US
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Telephone | 406-542-7525
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Fax | 406-829-0661
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. LOUIS X KATTINE
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Credential | MD
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Telephone | 406-542-7525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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