MEDICARE: WHITEHALL MEDICAL CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	184739200	OTHER	MT	FEDERAL WORK COMP CLINIC
2	27D0410762	OTHER	MT	PRACTICE CLIA ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124013719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITEHALL MEDICAL CLINIC

Provider Business Mailing Address
First Line	:	PO BOX 339
Second Line	:	108 FIRST ST W
City	:	WHITEHALL
State	:	MT
Zip	:	59759-0339
Country	:	US
Telephone Number	:	406-287-3003
Fax Number	:	406-287-3014

Provider Business Practice Location Address
First Line	:	108 W 1ST ST
Second Line	:
City	:	WHITEHALL
State	:	MT
Zip	:	59759-0339
Country	:	US
Telephone Number	:	406-287-3003
Fax Number	:	406-287-3014

Authorized Official
Title or Position	:	GENERAL PARTNER
Name	:	GAYLE FAYE SACRY
Credential	:	M.D.
Telephone Number	:	406-287-3003

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	10/24/2019

Similar Medicare Providers

1821083452 — GAYLE FAYE SACRY M.D.
Practice Location Address:

108 W FIRST ST
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59759-0339

Practice Phone: 406-287-3003
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1316932940 — TERRY DON REIFF D.O.
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1629064266 — STEVEN FOREST SACRY PA-C
Practice Location Address:

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59759-0339

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1508938986 — DENNIS K SACRY DDS
Practice Location Address:

108 FIRST STREET WEST
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59759

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Practice Fax:

1154480861 — WHITEHALL PHARMACY INC
Practice Location Address:

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1467505941 — TOWN OF WHITEHALL
Practice Location Address:

2 NORTH WHITEHALL STREET
WHITEHALL, MT
59759-0529

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Directions to “WHITEHALL MEDICAL CLINIC ” Practice Location

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