=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528494507
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MERRIT PSYCHIATRY PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2013
-----------------------------------------------------
Last Update Date | 09/23/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 CENTRAL AVE SUITE 301
-----------------------------------------------------
City | GREAT FALLS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59401-3179
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-868-2868
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 225 2ND ST S
-----------------------------------------------------
City | GREAT FALLS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59405-1828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-868-2868
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHIATRIST
-----------------------------------------------------
Name | DR. PATRICIA ANN CALKIN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 406-868-2868
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number | 10511
-----------------------------------------------------
License Number State | MT
-----------------------------------------------------