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1720607302 NPI number — MONTANA UPTON MD

NPI Number: 1720607302
Health Care Provider/Practitioner: MONTANA UPTON MD

Information about “1720607302” NPI (MONTANA UPTON MD) exists in 1720607302 in HTML format HTML  |  1720607302 in plain Text format TXT  |  1720607302 in PDF (Portable Document Format) PDF  |  1720607302 in an XML format XML  formats.

NPI Number : 1720607302 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1720607302",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "UPTON",
    "FirstName": "MONTANA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6222 WASHINGTON BLVD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "INDIANAPOLIS",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46220-1829",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "707-227-2869",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "355 W 16TH ST STE 3000",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "INDIANAPOLIS",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46202-2207",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "317-944-6467",
    "PracticeLocationAddressFaxNumber": "317-963-7085",
    "EnumerationDate": "04/13/2020",
    "LastUpdateDate": "07/22/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Y00000X",
          "TaxonomyName": "Otolaryngology Physician",
          "LicenseNumber": "01096256A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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