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General NPI Number Information
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NPI Number | 1639256688
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Entity Type | Individual
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Provider Name | WATSON MARK GUTOWSKI M.D., F.A.A.P., FACS
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 04/30/2020
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Provider Practice Location Address
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Address Line | 214 14TH AVE SW
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City | SIDNEY
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State | MT
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Zip | 59270-3521
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Country | US
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Telephone | 406-488-2100
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Fax | 406-488-2261
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Provider Business Mailing Address
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Address Line | 214 14TH AVE SW
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City | SIDNEY
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State | MT
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Zip | 59270-3521
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Country | US
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Telephone | 406-488-2100
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Fax | 406-488-2261
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 86559
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License Number State | MT
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